T2型结直肠癌淋巴结转移危险因素分析

IF 1.4 Q4 GASTROENTEROLOGY & HEPATOLOGY DEN open Pub Date : 2024-11-29 DOI:10.1002/deo2.70040

Yuriko Morita, Shin-ei Kudo, Yuki Takashina, Katsuro Ichimasa, Yuta Kouyama, Shigenori Semba, Kenichi Mochizuki, Osamu Shiina, Shun Kato, Takanori Kuroki, Shoji Shimada, Kenta Nakahara, Yusuke Takehara, Shunpei Mukai, Noriyuki Ogata, Takemasa Hayashi, Kunihiko Wakamura, Hideyuki Miyachi, Naruhiko Sawada, Tetsuo Nemoto, Toshiyuki Baba, Masashi Misawa

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摘要

目的评价T2型结直肠癌淋巴结转移（LNM）的危险因素，以优化内镜切除患者的选择。方法回顾2001年4月至2021年12月在日本本院连续行T2型结直肠癌根治性手术切除的患者记录。常规临床病理变量的数据从手术时的病理报告中检索。临床病理特征包括患者年龄、性别、肿瘤直径、形态、肿瘤位置、淋巴浸润、血管浸润、肿瘤分化、癌胚抗原和碳水化合物抗原19-9水平、淋巴结清扫数、腺瘤成分的存在、LNM。结果男性338例，女性320例，其中LNM 170例，占25.8%。多因素logistic回归确定了LNM的三个独立危险因素：淋巴浸润(优势比[OR]， 32.6；95%置信区间[CI]， 17.3-61.4；p & lt;0.0001)，女性(OR, 1.70；95% ci, 1.10-2.62；p = 0.02)，癌胚抗原水平升高(OR, 2.56；95% ci, 1.10-5.96；P = 0.03)。结论淋巴浸润、女性、高癌胚抗原水平显著增加T2结直肠癌发生LNM的风险。

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Lymph node metastasis risk factors in T2 colorectal cancer

Objectives

This study evaluates risk factors for lymph node metastasis (LNM) in T2 colorectal cancer to refine patient selection for endoscopic resection.

Methods

We reviewed records from consecutive patients who had undergone curative surgical resection of T2 colorectal cancer at our institution in Japan between April 2001 and December 2021. Data on conventional clinicopathologic variables were retrieved from the pathology reports at the time of surgery. The clinicopathological features included patient age, sex, tumor diameter, morphology, tumor location, lymphatic invasion, vascular invasion, tumor differentiation, carcinoembryonic antigen and carbohydrate antigen 19-9 levels, number of lymph node dissections, presence of adenoma component, and LNM.

Results

Among the patients (338 men, 320 women), 170 (25.8%) exhibited LNM. Multivariate logistic regression identified three independent risk factors for LNM: lymphatic invasion (odds ratio [OR], 32.6; 95% confidence interval [CI], 17.3–61.4; p < 0.0001), female sex (OR, 1.70; 95% CI, 1.10–2.62; p = 0.02), and elevated carcinoembryonic antigen levels (OR, 2.56; 95% CI, 1.10–5.96; p = 0.03).