| Objective: To investigate the clinical and pathological factors associated with lymph node metastasis in rectal cancer,and to provide a reference for clinical diagnosis and treatment.Methods: A total of 632 patients with rectal cancer from January 2015 to December2022 in the Department of XX were collected for this retrospective study.The case inclusion criteria were: 1.Patients with a tumor lower border less than 15 cm from the anal verge,2.Patients who underwent radical surgery for rectal cancer,3.Patients with adenocarcinoma on pathologic return,4.Patients with a detected number of lymph nodes greater than or equal to 12.The case exclusion criteria were: 1.Patients with intestinal duplication carcinoma,2.Patients with missing clinicopathological data.The lymph node metastasis rule of rectal cancer was analyzed in separate univariate and multivariate analyses.Results: Postoperative pathology of 632 patients with rectal cancer showed lymph node metastasis in 36.8%(233 / 632).The lymph node metastasis rate was 32.2%(130 / 403)in male patients and 44.9%(103 / 229)in female patients.The lymph node metastasis rate was 59.1%(13 / 22)in the young age group(aged < 45 years),36.8%(88 / 239)in the middle-aged group(aged 45-60 years),and 35.5%(132 / 371)in the old age group(aged > 60 years).The tumor morphology was that the lymph node metastasis rate was 38.9%(168 / 332)in the ulcer type group and 32.5%(65 /200)in the bulge type group.The lymph node metastasis rate was 37.2%(127 / 341)in the group with the lower margin of the tumor located above the peritoneal reflection,and 36.4%(106 / 291)in the group with the lower margin of the peritoneal reflection.The lymph node metastasis rate was 41.6%(94 / 226)in the carcinoma embryonic antigen(CEA)-elevated group and 34.3%(139 / 406)in the CEA normal group.The lymph node metastasis rate was 60.0%(33 / 55)in the group with elevated carbohydrate antigen 199(CA-199)and 34.6%(200 / 577)in the group with normal CA199.The tumor T stage was T1-,T2-,T3-,and T4 lymph node metastasis rates were 12.2%(5 / 41),18.1%(25 / 138),43.2%(189 / 437),87.5%(14 / 16),respectively.The tumor differentiation into poorly differentiated,moderately differentiated,and well differentiated lymph node metastasis rates were 44.4%(32 /72),39.3%(198 / 534),11.5%(3 / 26),respectively.The tissue type was mucinous adenocarcinoma group with lymph node metastasis rate of 44.7%(17 / 38),and the tissue type was adenocarcinoma group with lymph node metastasis rate of 36.3%(216/ 594).The lymph node metastasis rate was 70.1%(54 / 77)in the cancer nodule(TD)group and 33.3%(179 / 555)in the cancer nodule free group.The lymph node metastasis rate was 37.9%(11 / 29)in the neoadjuvant group before surgery and36.8%(222 / 603)in the no neoadjuvant group before surgery.Among them,gender,CA-199,tumor T stage,and the presence or absence of cancer nodules were statistically different in affecting lymph node metastasis.The data of 367 patients in this study had definite lymph node pathological stations,and the lymph node metastasis rates at stations 1,2,and 3 were 25.9%(95 patients),14.7%(54 patients),7%(26 patients),and 7.2%(24 / 333),5.7%(2 / 35),respectively,between the cancer node negative group and the positive group,while there was no significant difference between the two groups(P > 0.05).The tumor T stage was T1,T2,T3,T4 station 3metastasis rates were 4.0%(1 / 25),2.6%(2 / 76),8.5%(22 / 256),10.0%(1 / 10),respectively.Tumor T stage was positively correlated with lymph node metastasis at station 3(P = 0.036).Conclusion: Whether patients with rectal cancer developed lymph node metastasis was correlated with gender,tumor T stage,presence or absence of cancer nodules,CA-199;There was no significant correlation with age,tumor morphology,tumor size,tissue type,whether the procedure was neoadjuvant,or the degree of differentiation.Tumor T stage was positively correlated with lymph node metastasis rate at station 3. |
PDF Full Text Request