| To explore the principle of lymphatic metastasis and the invasive depth of the right hemiccolon cancer,in order to provid the evidence of operation improvement in early right hemiccolon cancer.Methods:After treating with LNRS the 24 right hemicolectomic specimens collected from 2008, January to 2010, January, the author groups and locates the collected lymph nodes in light of the Japanese clinical pathological stipulation for colorectal cancer, grades the tumor invasive depth according to TNM. Lateral lymph nodes fall into 3 groups, namely, group 1 (0-5cm), group 2 (5-10cm), group 3 (over 10cm). Use HE and IHE CK20 to detect the lymphatics.The differences between the lymphatic metastases in different stages of each group are analyzed.Results:(1)The averagea of total 492 lymph nodes of 24 specimens is 20.5, more than tradional techinc which is 8-15.(2)16 of the studied sufferers undergo lymphatic metastasis, accounting for 66.7%. (Among them, routine pathological HE staining cases stand at 11, IHC cases grow by 5). In total,492 lymph nodes are harvested, with 87 ones affected by metastasis, reaching 17.7%. (Among them, HE staining cases come to 61; IHC cases reach 87,). (p<0.05). The lymph node metastasis rate of IHC cases 66.7%(16/24) is more than HE 45.%(11/24), but p=0.146.(3) The lymph node metastasis rate and degree from staion are both 0% in pT1; The lymph node metastasis rate from staion N1-N3 are 28.5%,14.3%,0% and metastasis drgee are 10.3%,2.9%,0% in pT2; The lymph node metastasis rate from staion N1-N3 are 88.9%,55.6%,33.3% and metastasis drgee are 25.9%,16.9%,16.1% in pT3; he lymph node metastasis rate from staion N1-N3 are 100%,83.3%,66.6% and metastasis drgee are 32.4%,17.1%,20%.With the invasive aggravation, the lymph node metastasis rate and degree rises, tending to metastasize to the centrum. pT1+pT2's lymph node metastasis rate and degree is lower than pT3+pT4's in all of the N1-N3 stations. NO one case suffers lymphatic metastasis during pT1; 2 cases undergo lymphatic metastasis to staion Nl and N2 in the course of pT2. without even one case showing metastasis to station N3.(4)The lymph node metastasis rate and degree from 0-5cm grope to>10cm grope are both 0% in pT1; The lymph node metastasis rate from 0-5cm grope to >10cm grope are 28.5%,14.3%,0% and metastasis drgee are 13.9%.5.3%,0% in pT2; The lymph node metastasis rate from 0-5cm grope to>10cm grope are 88.9%.55.6%.33.3% and metastasis drgee are 40%.16.9%.5.6% in pT3; The lymph node metastasis rate from 0-5cm grope to>10cm grope are 100%,66.6%,33.3% and metastasis drgee are 37.1%,31.8%,17.6% in pT4.As the invasive depth worsens, the metastasis shows growth to the far end of the intestine longitude. The differences are mainly shown when juxtaintestinal lymph nodes are within 10cm reach of the tumor, p<0.05. pT1+pT2's lymph node metastasis rate and degree is lower than Pt3+pT4's in 0-5cm and 5-10cm gropes.NO one case suffers lymphatic metastasis during pT1; 2 cases undergo lymphatic metastasis in the course of pT2. without even one case showing metastasis to grope>10cm.(5) At the different stages the lymphatic metastases show no apparent differences in the lateral side of the tumor oral and the anal side.Conclusion:LRT can obtains more lymph nodes, which can up to scratch the standard not less than 13. This techinque is brifness,shortout,cheap and easy work LRT and immunohistochemistry can precisely detect the carcinogenic lymph nodes in the right hemicolon cancer, make certain of its metastatic pattern,have value in colon treatments and forecast the prognosis.For the radical operation on the well pathologically differentiated colorectal cancer with the hepatic flexure of colon at its early stage(pTland pT2), especially cnacer located in we can just clean the lymph nodes to the level of N2,preservie ileocolon artery and it's fraction branch, incise 10cm off the tumor. By this means, the caner cannot only be eradicated, but the ileocecal junction can be kept to improve the patients'living standard.
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