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结直肠神经内分泌肿瘤患者区域淋巴结转移的临床特点及影响因素探讨

Characteristics and risk factors of regional lymph node metastasis in colorectal neuroendocrine neoplasm

摘要目的:探讨结直肠神经内分泌肿瘤患者区域淋巴结转移的特点以及影响区域淋巴结转移的相关因素。方法对79例结直肠神经内分泌肿瘤患者的临床资料进行回顾性分析,采用多因素Logistic回归分析判断影响区域淋巴结转移的危险因素。结果区域淋巴结转移发生率为30.4%(24/79),其中肠旁淋巴结转移14例,肠系膜淋巴结转移6例,肠系膜根部中央组淋巴结转移4例,无一例发生跳跃式转移及肠系膜根部远处淋巴结转移。经单因素分析结果显示,肿瘤直径、黏膜面溃疡、浸润深度、病理分级、淋巴管浸润与结直肠神经内分泌肿瘤患者区域淋巴结转移有相关性(P<0.05);多因素Logistic回归分析结果显示,肿瘤直径、病理分级、淋巴管浸润是结直肠神经内分泌肿瘤患者区域淋巴结转移的独立危险因素(P<0.05)。结论结直肠神经内分泌肿瘤如肿瘤直径较大、病理分级G2或G3级且有淋巴管浸润者其区域淋巴结的转移率较高;行根治性切除术中应格外注意对肠旁淋巴结以及肠系膜淋巴结彻底清扫。

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abstractsObjective To investigate the characteristics and risk factors associated with regional lymph node metastasis in colorectal neuroendocrine neoplasm. Methods The clinical and pathological data of 79 patients with colorectal neuroendocrine neoplasm were retrospectively analyzed. The risk factors of regional lymph node metastasis were evaluated by multifactor Logistic regression analysis. Results The incidence of regional lymph node metastasis was 30.4% (24/79), among which para-intestinal lymph node metastasis was in 14 cases, mesenteric lymph node metastasis in 6 cases, and mesenteric root central lymph node metastasis in 4 cases. No patient was found to have skip metastasis and mesenteric root distant lymph node metastasis. The single factor analysis results showed that the tumor diameter, ulceration in mucous membrane, depth of invasion, pathological grading and invasion of lymphatic vessel were associated with regional lymph node metastasis in patients with colorectal neuroendocrine neoplasm (P<0.05). The multifactor Logistic regression analysis results showed that the tumor diameter, pathological grading and invasion of lymphatic vessel were was associated with regional lymph node metastasis in patients with colorectal neuroendocrine neoplasm (P<0.05). Conclusions The colorectal neuroendocrine neoplasm patients with larger tumor diameter, G2 and G3 of pathological grading and invasion of lymphatic vessel have higher incidence of regional lymph node metastasis; the mesenteric lymph node and para-intestinal lymph node should be paid special attention to in radical resection.

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