| Objective: To study the rules related to lymph node metastasis of left hemicolectomy cancer,to explore the relationship between lymph node metastasis and various factors related to left hemicolectomy,and to provide a basis for the standardizedclinical treatment of left hemicolectomy cancer.Methods: The data collected from August 2019 to September 2022 were collected from the preoperative and postoperative clinical records of patients who attended the Department of Gastrointestinal Surgery of the First Affiliated Hospital of Wannan Medical College and underwent laparoscopic radical surgery for left hemicolectomy for colon cancer,and the data collected were organized,and all patients were preserved with lymph node markers after surgery according tothe Ninth Edition of the Japanese Standard for the Treatment of Colorectal Cancer to analyze and study the appearance of metastasis in lymph nodes of lefthemicolectomy for colon cancer.We analyzed and studied the metastasis of lymph nodes in left hemicolectomized colon cancer,and investigated the factors related to the metastasis of lymph nodes in the No.253 group by counting andstudying the factors related to the metastasis of lymph nodes in left hemicolectomized colon cancer.Results: 1.There were 29 patients with lymph node metastasis among 66 patients with left hemi-colon cancer,and the lymph node metastasis rate was 43.9%,and the lymph node metastasis rates of paramedian lymph nodes,intermediate lymph nodes and central lymph nodes were 36.4%,6.1% and 3.0%,respectively,with statistically significant differences(P value < 0.05).2.Two cases of lymph node jumpingmetastases were seen in66 patients,one case(1.5%)of paramedian(-)intermediate(+)central(-)and one case(1.5%)of paramedian(-)intermediate(-)central(+).3.In this study,the lymph node metastasis rate was 41.5%(17/41)in male patients and 48.0%(12/25)in female patients,and there was no association between gender and lymph node metastasis of left hemicolectomy cancer(P=0.604 > 0.05);the lymph node metastasis rate was 41.9%(13/31)in patients aged less than or equal to 60 years,and 45.7%(16/35)in patients aged more than 60 years.The lymph node metastasis rate of patients aged less than or equal to60 years was 41.9%(13/31),and the lymph node metastasis rate of patients aged more than 60 years was 45.7%(16/35),and there was no association between age and lymph node metastasis of left hemicolectomy(P=0.758>0.05);the lymph node metastasis rate of patients with maximum tumor diameter less than or equal to 5 cm was 47.8%(22/46),and the lymph node metastasis rate of patients with maximum tumor diameter greater than 5 cm was 35.0%(7/20).=The lymph node metastasis rate was 40.0%(18/45)for patients with preoperative CEA less than or equal to 5ng/ml and 52.4%(11/21)for patients with preoperative CEA(carcinoembryonicantigen)greater than 5cm.=The lymph node metastasis rate was 44.9%(22/49)in patients with adenocarcinoma and 41.2%(7/17)in patients with mucinous adenocarcinoma and other patients,and there was no association between tumor tissue type and lymph node metastasis in left hemicolectomized colon cancer(P=0.790>0.05);the lymph node metastasis rate was14.3%(1/7)in highly differentiated patientsand 37.3%(1/7)in moderately differentiated patients.The lymph node metastasis rate was 37.2%(16/43)in patients with high differentiation,75.0%(12/16)in patients with low differentiation,and there was an association between the differentiation degree of malignancy and lymph node metastasis of left hemicolectasis(P=0.006<0.05);the lymph node metastasis rate was 60.0%(3/5)in patients with infiltrative type,55.3%(21/38)in patients with ulcerative type The lymph node metastasis rate of patients with T1+T2 stage was 0(0/11),and the lymph node metastasis rate of patients with T3+T4 stage was 52.7%(29/55),and the T stage of malignant tumor was associated with the lymph node metastasis of left hemicolectomy.There was an association(P=0.027<0.05).4.Independent risk factors associated with lymph node metastasis in left hemi-colon cancer included degree of tumor differentiation(OR=6.256,95% CI: 1.234 to 20.142,P=0.036),gross type(OR=5.452,95% CI: 1.112 to18.543 P=0.042),and T-staging(OR=12.457,95% CI: 1.954 to 63.241,P=0.013).Conclusion:1.Factors influencing regional lymph node metastasis in left hemicolectomy include the general type of malignancy,the degree of differentiation of malignancy and the T-stage of malignancy,which are also independent risk factors for the development of lymph node metastasis in left hemicolectomy.2.Lymph node metastasis of left hemi-colon cancer can occur in the parietal,middle and central lymphatic tissues,and there is lymph node jumping metastasis,so CME+D3 radical surgery is recommended. |
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