The Research Of Lymphatic Flow And Depth Of Invasion With Colonic Cancer

【Objective】The objective of this study is to evaluate lymphatic flow and depth of invasion with coloniccancer. It is expected to improve our understanding of the role of complete mesocolic excisionin the treatment of colonic cancer.【Methods】1. Methylene blue was used to inject into inside and outside part of the mesangial toobserve lymphatic drainage of colonic cancer2. The routine pathology examination were taken for distal tissue of colonic cancer andpositive and negative portion using routine H.E stain technique.3. The immunohistochemical stain was used for detecting the expression of CD34andD2-40in all tissue. Based on these，MVD and MLD of all tissue were statisticed andcompared.【Results】1. In the internal injection group，tumor and mesocolon were stained with theoutside of mesocolon unstained. In the external injection group，the outside tissue ofmesocolon was stained and the tumor and the intestinal wall were not stained.`2. In20cases, the proximal infiltration was founded in only three cases in first1mmproximal portion.3. MVD and MLV in edge of colonic cancer were significantly higher than that in distaltissue to cancer margin.It decreased in distal tissue along the anal direction.But CD34andD2-40were still founded in the negative control colonic tissue. MVD and MLD were notsignificantly different between in more than3mm tissue outside the mesocolon and innegative control colonic tissue.【Conclusions】1. The lymphatic drainage of the colon is limited in mesocolon. But when the tumorwas infiltrated to visceral fascia, lymph could be along with the new lymphatic vessels and return into the mesocolon.2. Both morphological and histochemical significant abnormality located in3mm distalmucosa. The preoperative evaluation of particular parameters related to DIS enabled theaccurate selection of colonic cancer to which the5mm rule of distal clearance can be applied.