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目的研究直肠癌系膜切缘和盆腔侧方转移的规律,为合理施行外科手术提供病理学依据。方法运用大组织切片技术,研究62例手术标本,并分析随访资料。结果有8例(12．9%)标本判定为环周切缘肿瘤浸润(CMI),其术后无病生存率低于切缘无肿瘤者(P=0．003)。12例(19．4%)标本存在盆腔侧方区域肿瘤转移,其中有8例(66．7%)为单一区域受累,4例(33．3%)为多重区域受累；术后无病生存率低于直肠系膜转移及无转移者(P=0．026)。本组盆腔侧方区域肿瘤转移中以直肠中动脉根部受累率最高(6/12,50．O%),其次为髂内动脉部(4/12,33．3%)和闭孔动脉区(3/12,25．0%)。结论直肠系膜CMI和盆腔侧方癌转移对直肠癌患者的术后生存时间有影响,应合理制定手术清扫范围,选用术后辅助治疗。
Objective To study the regularity of resection margin and pelvic lateral metastasis in rectal cancer and provide the pathological basis for the reasonable operation of surgery. Methods Tissue biopsy technique was used to study 62 surgical specimens and follow-up data were analyzed. Results Eight cases (12.9%) were diagnosed as circumferential incisional tumor infiltration (CMI), and their postoperative disease-free survival rate was lower than those without tumor (P = 0.003). Twelve cases (19.4%) had tumor metastases in the lateral pelvic region, of which 8 cases (66.7%) were involved in a single region and 4 cases (33.3%) were involved in multiple regions. The postoperative disease-free survival Rates were lower than those in patients with mesorectal metastasis and without metastases (P = 0.026). This group of pelvic lateral tumor metastasis in the middle rectum, the highest involvement rate (6 / 12,50.O%), followed by internal iliac artery (4/12, 33.3%) and obstructed artery area 3/12, 25.0%). Conclusion The rectal mesangial CMI and pelvic lateral metastasis have an impact on the survival time of patients with rectal cancer. The range of surgical resection should be reasonably established and postoperative adjuvant therapy should be selected.