结直肠癌中肿瘤出芽判断淋巴结转移的价值

目的:研究结直肠癌中肿瘤出芽判断淋巴结转移的价值.方法:2004年1月2007年12月有完整淋巴结病理学资料的结直肠癌手术患者92例,全数淋巴结检查,参照Ueno等的研究判断肿瘤出芽.结果:本组92例共切除淋巴结3036枚,平均每例取约33枚,92例结直肠癌中有47例出芽.肿瘤出芽与淋巴结转移的程度(pN分期)、肿瘤浸润深度呈显著性相关.肿瘤出芽对预测结直肠癌淋巴结转移的灵敏度、阴性预测值分别为90.91%和91.11%.结论:通过HE染色,镜下检测结直肠癌中肿瘤有无出芽来判断局部淋巴结转移,有助于快速确定结直肠癌患者局部淋巴结转移的状况,对及时辅助治疗具有实用价值.

Prognostic Value of Predicting Lymph Node Metastasis from Tumor Budding in Colorectal Cancer

Objective：To study the value of predicting lymph node metastasis from tumor budding in colorectal cancer. Methods：From January 2004 to December 2007, there were 92 patients with colorectal cancer who had received operation and with complete pathologic data of lymph node. All lymph nodes collected from these patients were examined. Tumor budding was identified according to the method mentioned by Ueno and his colleagues. Results：In total, 3036 lymph nodes were dissected from 92 patients, the average number is 33 lymph nodes/patients. Tumor budding were detected in 47 colorectal cancer patients. Strong correlation was found between tumor budding and the ratio of lymph node metastasis （pN stage）, the depth of invasion. The sensitivity and negative predictive value of predicting lymph node metastasis from tumor budding is 90.91% and 91.11% respectively. Conclusions：Lymph node metastasis can be predicted by tumor budding identified by HE staining in colorectal cancer. The stage of local lymph node metastasis can be evaluated rapidly by the status of tumor budding in colorectal cancer. Further, this finding is also valuable to choose proper assistant therapy.