淋巴结转移数目在结直肠癌预后判断中的意义

目的 :AJCC/ UICC TNM分期公布已 13年 ,国际上已得广泛应用 ,但国内至今未见用引分期文献报道。这种分期也不太严谨 ,未规定淋巴结检查数目和每枚淋巴结切片数。因此 ,研究结直肠癌淋巴结转移 (L NM)数目与预后的关系可弥补其不足。方法 :用自制的病理检查规范检查结直肠癌的淋巴结 ,分期采用AJCC/ U ICC TNM系统 ,同时作 Dukes分期 ,比较两种分期。结果 :76例共查淋巴结 3885枚 ,每例平均 5 1.5 2± 2 3.15枚。 4 3例有 L NM,L NM率为 5 6 .5 8%。N1 和 N2 病例 5年生存率有高度显著差别。L NM≥ 10枚和/或顶端、主干血管旁 L NM病例的预后极差。结论 :AJCC/ UICC TNM分期优于 Dukes分期 ;AJCC/ UICCTNM分期也有不足 ;提出一新的结直肠癌分期

Rely on the Number of Lymphnode Metastasis for Extimating Prognosis of Colorectal Cancer Alone

Objective: TNM stage system of colorectal cancer was published by AJCC/UICC 13 years ago and used widely all the world over. Yet no artical was presented in domestic literature until now. AJCC/UICC TNM stage system was imprecisely also, the number of nodes must be examined had not defined and the number of slices for each node Thus, It will be help to study the relationship between the number of LNM and nor the prognosis in colorectal cancer. Methods: The operative specimens of colorectal cancer were examined according to the pathologic rule estabished by ourselves. The stage was taken according to AJCC/UICC TNM system and Dukes stage and the comparison was made between two stages system. Results: A total 3885 nodes were harvested from 76 cases. An average of 51.52±23.15 nodes for each case were harvested. 43 patients shown LNM with a ratio of LNM 56.58%. The prognosis of patients with N1 stage was much better than that of patients with N2 stage. When prominent nodes or nodes beside named vessels show metatasis and the number of LNM more than or equal to 10, the prognosis was very poor. Conclusion: AJCC/UICC TNM stage system shown much better prediction than Dudes stage. Nevertheless, the shortages of AJCC/UICC TNM system existed clearly. Thus, we bring forward a new stage system in colorectal cancer.