[Risk factors for lymphatic metastasis from pT1 colorectal adenocarcinoma].
[Risk factors for lymphatic metastasis from pT1 colorectal adenocarcinoma].
复制标题
pT1期结直肠腺癌淋巴转移的危险因素[J].
DOI：
--
复制
发表时间：
2003
期刊：
影响因子：
--
通讯作者：
M. Vieth
中科院分区：
文献类型：
--
作者：
P. Deinlein;U. Reulbach;M. Stolte;M. Vieth
在过去的20年里，内镜下切除结直肠腺瘤已被广泛接受为开放手术切除的替代方法。甚至结直肠腺癌也不排除。关键的问题是什么时候手术治疗仍然优于内镜切除作为主要治疗。一个很好的指标是淋巴结转移的频率，这应该与外科手术本身的总体风险进行比较。组织学检查可将早期结直肠腺癌细分为低危组和高危组。高危情况的经典参数是淋巴浸润、分化差和不完全切除（R1）。最近讨论的其他危险因素是浸润到粘膜下层的下三分之一（sm3）和肿瘤细胞在侵袭前的解离（出芽）。根据文献和对我们自己患者的分析，我们证明了这些新标志物与淋巴结转移风险升高之间的正相关关系。
During the last 20 years, endoscopic removal of colorectal adenoma has become widely accepted as a replacement for removal by open surgery. Even colorectal adenocarcinomas are not excluded. The key question is when surgical treatment should still be preferred over endoscopic removal as the primary treatment. One good indicator is the frequency of lymph node metastasis, which should be compared with the overall risk involved in the surgical procedure itself. Histological examination allows subdivision of early colorectal adenocarcinomas into low-risk and high-risk groups. Classical parameters for a high-risk situation are lymphatic invasion, poor differentiation, and incomplete removal (R1). Additional risk factors that have recently been discussed are infiltration into the lower third of the submucosal layer (sm3) and dissociation (budding) of the tumour cells at the invasion front. Drawing on the literature and an analysis of our own patients, we demonstrate a positive correlation between these new markers and an elevated risk of the presence of lymph node metastasis.