<原著>クリアリング法による大腸癌転移様式と遠隔成績からみたリンパ節分類の評価

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The lymph node metastasis in 322 cases of colorectal cancer was studied by the modified clearing method and we evaluated the Japanese General Rules for Clinical and Pathological Studies on Cancer of Colon, Rectum and Anus (General Rules) and the pTNM classification by UICC were evaluated. Central spread was more pronounced than was longitudinal spread in patients with left colon cancer, while there was no difference in patients with right colon cancer. The metastatic rate in longitudinal spread varied with colon cancer region. Analysis of the relationship between the site of primary tumor and location of the major blood vessels revealed that the tumor more frequently metastasized into the lymph nodes located near the main blood vessels, regardless of whether the lymph node was oral or anal to the primary tumor. In patients with rectosigmoid and upper rectal cancer, upward spread was more frequent than longitudinal spread, while in those with lower rectal cancer longitudinal spread was more frequent. These findings indicate that spread from the upper margin of the tumor to Sudeck's point is longitudinal rather than upward. The 5-year survival rate after curative resection of patients with colon cancer was 72.6% for n_1,59.8% for n_2 and 30.0% for n_3 (classified according to the General Rules ), While that in pN2 patients (45.7%) was almost the same as that in pN3 patients (45.4% : pTNM classification). In patients with rectal cancer, the metastatic rate was 22.8% for n_1,24.0% for n_2,and 7.6% for n_3,The 5-year survival rate for curative resection with rectal cancer was 70.9% for n_1,65.9% for n_2 and 41.7% for n_3,while that in pN1 patients (72.7%) was almost the same as that in pN2 patients (75.0%). Lateral metastasis, though not included in the category of regional lymph node metastasis in the pTNM, was observed in 12.8% of those with lower rectal cancer. Based on the metastatic rate, the lower rectum is considered to show regional lymph node metastasis. Thus, the General Rules are more useful in assessing the prognosis of colorectal cancer than is the pTNM.
近畿大学の論文
1993-03-25

<原著>クリアリング法による大腸癌転移様式と遠隔成績からみたリンパ節分類の評価

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