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Clinical Studies of Lymph Node Metastasis in Colorectal Cancer

Author: ZhouHongJian
Tutor: LiangJunLin
School: Guangxi Medical University
Course: Clinical Surgery
Keywords: colorectal cancer lymph node metastasis clinicalpathological factor distribution nodal stage lymph node ratio clinicopathological factor
CLC: R735.3
Type: Master's thesis
Year: 2010
Downloads: 84
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Abstract


Background & Objective Colorectal cancer is one of the most common malignancies in the world and a leading cause of cancer deaths with-an increasing incidence in more recent years. Lymph node metastasis is the most common form of spread in colorectal cancer, and indications for neoadjuvant are based on pretherapeutic lymph node status. At present, pretherapeutic nodal stage assessment depends on imaging studies, and the accuracy of the present imaging studies is limited. This study was designed to investigate the clinicalpathological factors related with lymph node metastasis in colorectal cancer. Methods The clinicalpathological data of 291 patients with colorectal cancer who underwent surgical resection in the First Affiliated Hospital of Guangxi Medical University from April 2008 to December 2009 was retrospectively analyzed. First, the associations between lymph node metastasis and clinicopathological factors were evaluated by univariate analysis (chi-square test). Second, the associations between lymph node metastasis and the univariate analysis significant (P<0.05) clinicopathological factors were evaluated by logistic multiple regression analysis.Results Univariate analysis showed that gender, age, tumor location, bowel wall circumference, tumor size, gross findings, and histological type was not related with lymph node metastasis, but tumor differentiation, depth of bowel wall invasion and preoperative serum carcinoembryonic antigen (CEA) level were significantly correlated with lymph node metastasis. In well-differentiated, moderately differentiated, poorly differentiated (including undifferentiated) tumors, the lymph node metastasis rate was 20.0%,54.6%,78.8%, respectively, with significant differece in the lymph node metastasis rates (P<0.05). With the lower degree of differentiation, the rates of lymph node metastasis were higher. In tumor with depth of bowel wall invasion into mucosa, muscularis, serosa, serous membrane outer layer, the lymph node metastasis rate was 23.1%,32.4%, 61.9%,67.7%, respectively, with significant differece in the lymph node metastasis rates (P<0.05). With the depth of invasion increasing, the lymph node metastasis rate increased. Logistic multivariate regression analysis showed tumor differentiation and depth of bowel wall invasion were significantly related with lymph node metastases.Conclusion Tumor differentiation and depth of bowel wall invasion are important risk factors for lymph node metastasis in colorectal cancer. Backgroung & Objective:Lymph node metastasis is the most common form of spread in colorectal cancer, and regional lymph node metastases are indicators of an increased risk of recurrence after operation. The present imaging methods concerning regional lymph nodes have limited accuracy. This study was designed to investigate the distribution of metastatic lymph node, nodal stage, lymph node ratio and their relation with clinicopathological factors in patients with colorectal cancer.Methods The clinicopathological data of 106 colorectal cancer patients with lymph node metastasis and over 12 examined lymph nodes was retrospectively analyzed. The distribution of metastatic lymph node, nodal stage, lymph node ratio and their relation with clinicopathological factors were evaluated.Results The overall reflux lymph node metastasis rate and the skipping metastasis rate was 69.8% and 30.2%, respectively. Age, gender, bowel wall circumference, tumor size, gross findings, histological type and depth of bowel wall invasion, preoperative serum CEA level was not related with nodal stage, but tumor differentiation were significantly correlated with nodal stage. Age, gender, tumor location, bowel wall circumference, gross findings, tumor size, histological type and depth of bowel wall invasion was not related with LNR, but preoperative serum CEA level and tumor differentiation were significantly correlated with LNR.Conclusion Tumor differentiation may be a important factor related with nodal stage, and preoperative serum CEA level and tumor differentiation may be important factors related with LNR in colorectal cancer patients with lymph node metastasis.

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CLC: > Medicine, health > Oncology > Gastrointestinal Cancer > Intestinal neoplasms
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