Abstract：【Objective】To investigate the factors influencing the number of lymph nodes detected after laparoscopic radical resection of rectal cancer.【Methods】Clinical data of 87 patients with rectal cancer undergoing laparoscopic radical resection of rectal cancer from February 2016 to March 2017 were selected. According to whether the patients received neoadjuvant therapy (including radiotherapy and chemotherapy) before operation, they were divided into neo-adjuvant therapy group and non-neoadjuvant treatment group. All kinds of clinicopathological factors which may affect the number of lymph nodes detected were analyzed.【Results】The maximum diameter of the tumor, the length of the specimen, the depth of tumor invasion and the number of lymph nodes detected by the operation were significantly correlated, the difference was statistically significant (P<0.05). However, sex, age, tumor location, pathological type, tumor differentiation, TNM staging, preoperative CEA and surgical procedure had no correlation with the number of lymph nodes detected (P>0.05). The average number of total lymph nodes in the non neoadjuvant therapy group, the average number of intestinal lymph nodes and the number of mesenteric lymph nodes were significantly higher than those in the neoadjuvant therapy group, the difference was statistically significant (P<0.001). The maximum diameter of the tumor, the length of the specimen, the depth of tumor invasion, and whether the neoadjuvant therapy was accepted or not were independent factors affecting the number of lymph nodes more than 12.【Conclusion】The maximum diameter of tumor, the length of specimen, and the depth of tumor invasion were related to the number of lymph nodes detected in rectal cancer patients. Patients with minimal tumor diameter, small specimen length, low depth of tumor infiltration, and preoperative neoadjuvant therapy are more likely to detect 12 lymph nodes in postoperative specimens.
孔雷,刘彬,陈建军,孔营. 腹腔镜直肠癌根治术中淋巴结获检数量的相关因素分析[J]. 医学临床研究, 2018, 35(3): 464-467.
KONG Lei, LIU Bin, CHEN Jian-jun, et al. Analysis of Factors Related to the Number of Lymph Nodes Detected in Laparoscopic Radical Resection of Rectal Cancer. JOURNAL OF CLINICAL RESEARCH, 2018, 35(3): 464-467.
[1] 张兴茂,周志祥.结直肠癌根治术淋巴结检出数目的临床意义[J].实用肿瘤杂志,2014,29(3):209-212. [2] O'Boyle S,Stephenson K.More is better:Lymph node harvesting in colorectal cancer[J].Am J Surgery,2017,213(5):926. [3] Mechera R,Schuster T,Rosenberg R,et al.Lymph node yield after rectal resection in patients treated with neoadjuvant radiation for rectal cancer:A systematic review and meta-analysis[J].Eur J Cancer,2017 ,72(52):84-94. [4] Matsuo H,Harada Y,Minamikawa T,et al.Efficient fluorescence detection of protoporphyrin IX in metastatic lymph nodes of murine colorectal cancer stained with indigo carmine[J].Photodiagnosis Photodyn Ther,2017,52(21):324-330. [5] Li Q,Wang C,Li Y,et al.Lymph node status as a prognostic factor after palliative resection of primary tumor for patients with metastatic colorectal cancer[J].Oncotarget,2017,32(11):234-240. [6] Benson AB,Venook AP,Bekaii-Saab T,et al.Rectal cancer.Version 2[J].J Natl Compr Canc Netw,2015,13(6):719-728. [7] Arnold A,Kloor M,Jansen L,et al.The association between microsatellite instability and lymph node count in colorectal cancer[J].Virchows Arch,2017,471(1):57-64. [8] 戎祯祥.腹腔镜结直肠癌根治术的血管处理及淋巴结清扫技巧[J].中华腔镜外科杂志(电子版),2016,12(04):534-537. [9] Quaresima S,Paganini AM,D'Ambrosio G,et al.Modified sentinel lymph node technique combined with Endoluminal Loco-Regional Resection for the treatment of rectal tumors:a fourteen year experience.Colorectal disease[J].Ass Coloproctol Great Br Ire,2017,12(4):466-472. [10] Lee JY,Seo EH,Oh CS,et al.Impact Of Circulating T Helper 1 And 17 Cells in the Blood on Regional Lymph Node Invasion in Colorectal Cancer[J].J Cancer,2017,8(7):1249-1254. [11] 孙涛,周鑫,傅卫,等.新辅助放化疗对腹腔镜中低位直肠癌根治术围术期结果的影响[J].中国微创外科杂志,2017,65(03):197-201. [12] 田相安,杨成菊,丁元升,等.纳米炭导航腹腔镜中低位直肠癌根治术个体化淋巴结清除的临床研究[J].中国现代普通外科进展,2017,52(03):188-192. [13] 吴建海,韩方海,陈进忠.Ⅰ~Ⅲ期结直肠癌淋巴结转移比率与预后关系[J].中华结直肠疾病电子杂志,2016,5(2):138-147.
2018, Vol. 35 
