The Study Of The Correlation Of The Lymph Node Metastasis Mode With Recrudescence Metastasis And Prognosis Of Rectal Carcinoma

Objective:Investigate the correlation between the lymph node metastasis mode with recrudescence metastasis and prognosis of rectal carcinoma, to provide a theoretical basis for clinic diagnosis and combined therapy after surgery.Method:Selected our hospital from2001to2005 colorectal cancer radical surgery 1473 patients with a complete record of information Duck's C of 80 patients for the study, all of the 80 cases that by Dixon operation,without chemoradiation therapy,all of the 80 cases that were finally diagnosed by pathology and colonoscope with complete follow up data entered the study were retrospectively analyzed. All the lymph nodes that eliminated from the patients were stained by HE and immunity class CK20 staining,and then assessmented whether lymph nodes were metastasised or not. The lymph nodes were classified, typed, counted, and measured size and so on under the light microscope. The relationship between clinicopathological factors (age, gender, tumor size, lymph nodes size, metastasise mode, differentiation degree, infiltrate depth)and that metastasis extension, recurrence, distant metastasis and prognosis were univariate and multivariate analysis were performed by SPSS 13.0 on the lymph node metastasis, recurrence, distant metastasis and prognosis. The relationship between clinicopathological variables and lymph node metastasis, recurrence, and distant metastasis is evaluated by cross tabs and logistic regression. The survival data were were analyzed by univariate (Long-rank) and multivariate (Cox model) methods.Result:Of the 80 patients, There is no dependablity between lymph nodes metastasis extension of rectum cancer and that gender, age, tumor size depth of invasion of patients, and also the recurrence, distant metastasis and 5 year survival rate. The 80 patients were devided into two groups by the age≤60 years and>60years, the lymph nodes metastasis extension were 22.67%,19.74% respectively, there is no significant difference between two groups. According to lymph nodes size,80 cases were separated to three groups:<5mm,5-10mm and>10mm.The metastasis extension were 18.1%,22.52%,19.23% respectively, without significant difference, There is no dependablity between lymph nodes size and that recurrence, distant metastasis and 5 year survival rate.In the lymph nodes metastasis mode, the metastasis extension were 15.09%,19.34%,25.9%,27.5% respectively, There is no significant dependablity between typeⅠand typeⅡ, so did typeⅢand typeⅣ,but significant dependablity between that typeⅠandⅡand that typeⅢandⅣ. Significant dependablity exist between metastasis mode and that recurrence, distant metastasis and 5 year survival rate.In the differentiation degree, because there is only 1 high differentiation degree patient, so 80 patients were devided into two groups:The High-midrange and poor differentiation. The lymph nodes metastasis extension were 16.31%,26.68%, respectively, Significant dependablity exist between the two groups, the differenti-ation degree of lymph nodes have significant dependablity with that recurrence, distant metastasis and 5 year survival rate. Univariate and multivariate analysis show that lymph nodes metastasis mode and lymph nodes differentiation degree were the pridictors for prognosis of rectum cancer.Conclusion:1.There is no significant dependablity between that the age,gender, tumor size, lymph nodes size and that lymph nodes metastasis, recurrence, distant metastasis and 5 year survival rate.2.There is significant dependablity between lymph nodes metastasis mode, lymph nodes differentiation degree and that recurrence, distant metastasis and survival rate.3.Lymph node metastasis mode and differentiation of lymph nod are metastasis and recurrence independent prognostic factors in colorectal cancer.4.1f the lymph nodes metastasis mode is typeⅢor typeⅣ,and or differentiation degree is poor, the lymph nodes clearance should be enlargemented in operation or the combined therapy should be performed after surgery.