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结、直肠癌淋巴结转移于分期重要性早在1932年的Dukes分期中就已明确,有淋巴结转移就列入C期。此后众多修正案均无实质进展。直至1984年胃肠道肿瘤研究协作组(GITSG)第一次引入定量病理学内容,1～4枚淋巴结转移(LNM)为C_1期,≥5枚LNM为C_2期。AJCC1986年、UICC1988年按TNM系统分期,凡淋巴结转移皆为Ⅲ期,并将N项再分,N_1为1～3枚肠壁旁LNM,N_2为≥4枚LNM。究竟N项再分亚期是以3枚LNM为界抑4枚为界,颇有争议,多数学者认为TNM分期优于GITSG分期,我们病例的经验也证实这一点,并且提出淋巴结转移度与分期及预后相关。
Lymph node metastasis in colorectal cancer and rectal cancer has been identified in the Dukes stage as early as 1932. Lymph node metastasis was included in stage C. Since then many amendments have made no substantive progress. Until 1984, the GITSG introduced the quantitative pathology content for the first time. 1 to 4 lymph node metastases (LNM) were C 1 phases, and ≥ 5 LNMs were C 2 phases. AJCC 1986 and UICC 1988 were staged according to TNM system. All lymph node metastases were stage III and subdivided into N items. N_1 was 1 to 3 LNM around the intestine, and N_2 was ≥ 4 LNM. It is controversial that the N subdivision subperiods are bounded by 3 LNMs bounded by 4 pieces. Most scholars believe that the TNM stage is superior to the GITSG stage. Our experience in the cases also confirms this, and proposes the degree of lymph node metastasis and staging. And prognosis.