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目的探讨直肠癌系膜内癌灶、微转移灶的分布规律。方法联合运用大组织切片与组织芯片技术,研究四川大学华西医院普外科2002年3月至2002年5月间的31例全直肠系膜切除(TME)手术标本。结果直肠系膜内癌灶349处,33%位于外带,肿瘤同侧多于对侧(P<0·05)。肿瘤远端系膜内播散4例,距离1·0~3·5cm。环周切缘癌浸润12例,与肿瘤位置无关。检获淋巴结计972枚,其中癌转移淋巴结128枚,微转移发生率与肿瘤分期无关。结论按照原则手术,保持盆脏筋膜完整性是减少肿瘤局部残留的有效措施。进展期直肠癌术后辅助放化疗是必要的。
Objective To investigate the distribution of intramural and focal micrometastasis in rectal cancer. Methods The combined use of large tissue sections and tissue microarray technology to study 31 cases of total mesorectal excision (TME) surgical specimens from March 2002 to May 2002 in West China Hospital of Sichuan University. Results There were 349 intracranial mesorectal lesions, 33% of which were located on the outside of the mesothelium. The tumors were on the ipsilateral side (P <0.05). Tumor distal mesangial disseminated in 4 cases, the distance 1.0 ~ 3.5cm. Peripheral border cancer infiltration in 12 cases, has nothing to do with the location of the tumor. A total of 972 lymphatic nodes were seized, of which 128 were cancerous lymph nodes. The incidence of micrometastases was unrelated to the tumor stage. Conclusion According to the principle of surgery, to maintain the integrity of the pelvic fascia is an effective measure to reduce local tumor residues. Postoperative adjuvant chemoradiation is necessary for advanced rectal cancer.