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目的:探讨结直肠癌淋巴结转移规律及其影响因素。方法:分类整理武汉大学中南医院1990年1月-2007年12月手术治疗的结直肠癌病人的病历资料1 127例,采用卡方检验及Logistic多因素回归分析方法研究淋巴结转移与临床病理参数之间的相关性。结果:单因素分析显示,患者的性别、肿瘤部位与淋巴结转移无明显相关性。影响淋巴结转移的因素有患者的年龄、肿瘤的大小、肿瘤浸润肠壁的深度和分化程度。40岁以下的年轻结直肠癌患者淋巴结转移率明显高于40岁以上者(P<0.01)。淋巴结转移率随肿瘤直径的增大而增高(P<0.001)。肿瘤浸润肠壁的深度增加,淋巴结转移率增加(P<0.001)。肿瘤的分化程度越低,淋巴结转移率越高(P<0.001)。Logistic多因素回归分析显示,结直肠癌淋巴结转移与肿瘤浸润肠壁的深度和肿瘤的分化程度相关,相关因素与淋巴结转移的程度依次为肿瘤浸润肠壁的深度>肿瘤的分化程度,在所选因素中肿瘤浸润肠壁的深度是影响淋巴结转移的最重要因素。结论:结直肠癌淋巴结转移与肿瘤浸润肠壁的深度和分化程度相关,其中肿瘤浸润肠壁的深度是影响淋巴结转移的最重要因素。
Objective: To investigate the rule of lymph node metastasis and its influencing factors in colorectal cancer. Methods: A total of 1 127 cases of colorectal cancer patients who underwent surgery from January 1990 to December 2007 in Central South Hospital of Wuhan University were classified. Logistic regression analysis and multivariate logistic regression analysis were used to study the relationship between lymph node metastasis and clinicopathological parameters Relevance between. Results: Univariate analysis showed that there was no significant correlation between the patient’s sex, tumor location and lymph node metastasis. Factors affecting lymph node metastasis are the age of the patient, the size of the tumor, the depth and differentiation of the tumor-infiltrating intestinal wall. Lymph node metastasis in younger colorectal cancer patients under 40 years old was significantly higher than those over 40 years old (P <0.01). Lymph node metastasis rate increased with tumor diameter (P <0.001). The depth of tumor infiltrating intestinal wall increased, lymph node metastasis rate increased (P <0.001). The lower the degree of tumor differentiation, the higher the rate of lymph node metastasis (P <0.001). Logistic multivariate regression analysis showed that lymph node metastasis of colorectal cancer correlated with the depth of tumor infiltrating intestinal wall and the degree of tumor differentiation. The related factors and the degree of lymph node metastasis were the depth of tumor infiltrating intestinal wall> the degree of tumor differentiation. Factors in the depth of tumor infiltration of the intestinal wall is the most important factor affecting lymph node metastasis. Conclusion: The lymph node metastasis of colorectal cancer is related to the depth and differentiation of tumor infiltrating intestinal wall. The depth of tumor infiltrating intestinal wall is the most important factor affecting the lymph node metastasis.