The classification of cancer of the rectum
The classification of cancer of the rectum
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DOI：
10.1002/path.1700350303
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发表时间：
1932-01-01
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影响因子：
--
通讯作者：
Dukes, CE
中科院分区：
文献类型：
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作者：
Dukes, CE
直肠癌根据扩散程度可分为A、B、C三种情况。在A例中，生长仅限于直肠壁;在B例中，有直肠外扩散，但无淋巴转移;在C例中，转移存在于区域淋巴结中。三组的手术死亡率及术后生存期有显著性差异。我们有理由相信，在A病例中，直肠切除术可使疾病完全根除，手术治疗的良好结果证实了以前的观点，即直肠癌直接连续扩散到直肠外组织后才发现淋巴转移。B例预后良好，但稍差于A例。C例手术治疗的结果非常令人失望。本文讨论了Broders方法的组织学分级的范围和局限性，并得出结论，肿瘤分级对预后也有价值，但不适用于诊断切除的碎片。
Cancers of the rectum can be divided into A, B, and C cases according to the extent of spread. In A cases, the growth is limited to the wall of the rectum; in B cases, there is extrarectal spread but no lymphatic metastases; in C cases, metastases are present in the regional lymph nodes. A striking difference is found in the operative mortality rate and in the survival period after operation in these 3 groups. There is reason to believe that in A cases the disease is completely eradicated by rectal excision and the excellent results of operative treatment confirm the opinion previously expressed that lymphatic metastases are not found until a rectal carcinoma has spread by direct continuity to the extrarectal tissues. A good prognosis is justified also in B cases, though slightly less favorable than in A. The results of surgical treatment in C cases are very disappointing. The scope and limitations of histological grading by Broders'' method are discussed and the conclusions reached that grading of a tumor is also of value for prognosis, though not when applied to fragments removed for diagnosis.