Process of distant lymph node metastasis in colorectal carcinoma: implication of extracapsular invasion of lymph node metastasis.
Process of distant lymph node metastasis in colorectal carcinoma: implication of extracapsular invasion of lymph node metastasis.
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DOI：
10.1186/1471-2407-11-216
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发表时间：
2011-06-02
期刊：
影响因子：
3.8
通讯作者：
Kuwano H
中科院分区：
文献类型：
--
作者：
Fujii T;Tabe Y;Yajima R;Yamaguchi S;Tsutsumi S;Asao T;Kuwano H
我们以前证明，转移性前哨淋巴结的囊外浸润（ECI）与乳腺癌患者的非前哨淋巴结阳性显著相关。然而，大肠癌患者肿瘤细胞向远处淋巴结转移扩散的机制尚不完全清楚。在这项研究中，我们调查的因素，可能会决定额外的区域淋巴结转移的可能性时，发现在结直肠癌N1部位的淋巴结转移，特别是集中在ECI的存在。228例接受结直肠切除术的连续患者被确定纳入本研究，其中37例（16.2%）在N1部位有阳性淋巴结。这37例病例中，有6例在N2部位淋巴结有额外转移。我们回顾了这些病例的临床病理特征，并对数据进行统计分析。在单变量分析中，N1位点的ECI是与N2位点癌细胞存在显著相关的唯一因素。其他因素，包括阳性淋巴结的数量，原发肿瘤的淋巴血管浸润，肿瘤大小和肿瘤浸润深度，与N2部位的转移无关。我们的研究结果表明，在N1部位转移淋巴结的ECI的存在与N2部位的进一步转移相关。这些发现意味着ECI可能指示结直肠肿瘤细胞向远处淋巴结扩散的能力。
We previously demonstrated that extracapsular invasion (ECI) at a metastatic sentinel node was significantly associated with the presence of positive non-sentinel nodes in patients with breast cancer. However, the mechanism of metastatic spreading of tumor cells to distant lymph nodes in patients with colorectal carcinoma is not fully understood. In this study, we investigated the factors that may determine the likelihood of additional regional lymph node metastasis when metastasis is found in nodes at the N1 site in colorectal cancer, especially focusing on the presence of ECI. Two hundred and twenty-eight consecutive patients who underwent colorectal resection were identified for inclusion in this study, of which 37 (16.2%) had positive lymph nodes at the N1 site. Six of these 37 cases had additional metastasis in N2 site lymph nodes. We reviewed the clinicopathological features of these cases and performed statistical analysis of the data. In the univariate analysis ECI at the N1 site was the only factor significantly associated with the presence of cancer cells in the N2 site. Other factors, including number of positive lymph nodes, lymphovascular invasion of the primary tumor, tumor size and tumor depth of invasion, were not associated with metastatic involvement at the N2 site. Our results suggest that the presence of ECI at metastatic lymph nodes at the N1 site is correlated with further metastasis at the N2 site. These findings imply the possibility that ECI might indicate the ability of colorectal tumor cells to disseminate to distant lymph nodes.
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影响因子：
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