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目的探讨中低位直肠癌新辅助放化疗后安全手术切缘的临床病理分析。方法 43例进行新辅助放化疗以及手术治疗的中低位直肠癌患者作为本次研究的对象,收集所有患者的新鲜手术标本,纵行连续切片实施病理学检查,回顾性分析患者的远切断长度、近切断长度以及环周切缘阳性率。结果 43例中低位直肠癌患者的远切断长度为(3.2±0.3)cm,近切断长度为(15.3±3.3)cm,环周及远端切缘阳性率为0;残余肿瘤细胞Ki-67增殖指数放化疗前后对比差异有统计学意义(P<0.05)。结论中低位直肠癌患者通过实施新辅助放化疗后,肿瘤出现程度不一的收缩,术中需要在体切除肿瘤下缘肠壁2 cm,环周切除面积依据完全切除肿瘤区域残余瘢痕组织为标准。
Objective To investigate the clinicopathological analysis of surgical margin after neoadjuvant chemoradiotherapy in low and middle rectal cancer. Methods 43 patients with neoadjuvant chemoradiotherapy and surgical treatment of low and middle rectal cancer patients were selected as the object of this study. Fresh surgical specimens of all patients were collected and serially sectioned longitudinally for pathological examination. The distant cut-off length of the patients was retrospectively analyzed. Near the cut length and circumferential margin positive rate. Results The length of distal resection was (3.2 ± 0.3) cm in 43 patients with low or medium rectal cancer, the length of proximal resection was (15.3 ± 3.3) cm, and the positive rate of the peripheral and distal margins was 0. The Ki-67 proliferation index The difference between before and after chemotherapy was statistically significant (P <0.05). Conclusions Neoplasm rectal cancer patients with neoadjuvant chemoradiotherapy may have different degrees of tumor shrinkage. Surgical excision of the lower edge of the intestinal wall should be performed in 2 cm. The circumference of the resection area should be based on the total scar tissue removed from the tumor area .