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目的探讨低位直肠癌盆腔侧方淋巴结转移、微转移规律及其对预后的预测价值。方法运用大组织切片、组织芯片研究67例低位直肠癌手术标本,并分析其随访资料。结果 12例标本检获盆腔侧方淋巴结癌转移,另有10例存在微转移,82.9%的转移淋巴结直径<5 mm。髂内血管、闭孔、髂内远端内侧分支等处淋巴结受累率较高。侧方转移、微转移病例术后复发多,生存时间短。结论低位直肠癌存在盆腔侧方转移,各区域受累率不一。侧方转移病例预后差,提示术前/术后辅助治疗的价值。
Objective To investigate the pelvic lateral lymph node metastasis and micrometastasis in low rectal cancer and its prognostic value. Methods Large tissue sections and tissue microarrays were used to study 67 cases of low rectal cancer and their follow-up data were analyzed. Results In 12 cases, pelvic side lymph node metastases were obtained, and micrometastases were found in 10 cases and metastatic lymph nodes <5 mm in 82.9% of cases. Internal iliac vessels, obturator, internal iliac distal medial branches and other lymph node involvement rate higher. Lateral metastasis, micrometastases cases of recurrence and survival time is short. Conclusion There is pelvic lateral metastasis in low rectal cancer, with different rates in different regions. The poor prognosis of patients with lateral metastases, suggesting the value of preoperative / postoperative adjuvant therapy.