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首页> 外文期刊>Diagnostic and therapeutic endoscopy >Indication for Endoscopic Resection of Submucosal Colorectal Carcinoma: Special Reference to Lymph Node Metastasis
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Indication for Endoscopic Resection of Submucosal Colorectal Carcinoma: Special Reference to Lymph Node Metastasis

机译：内镜切除粘膜下结直肠癌的适应症：淋巴结转移的特别参考。

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We investigated the relationship between histological factors and lymph node metastasis in77 lesions with submucosally invasive colorectal carcinomas to establish useful criteria forlesions in which endoscopic treatment alone results in cure of malignancy. There were positivecorrelations between histological factors, including the level of invasion, the histologic grade,presence or absence of lymphatic invasion, presence or absence of budding, and lymph nodemetastasis (p< 0.05,p< 0.05,p< 0.005,p< 0.01). The presence or absence of venousinvasion did not influence lymph node metastasis. Laparoscopic surgery involving lymph nodedissection should be indicated for sm1 carcinoma lesions with unfavorable histological factors.In lesions diagnosed as sm2 or sm3 prior to resection, intestinal resection involving lymph nodedissection by laparoscopic surgery should be directly performed without endoscopic resection.In treating submucosally invasive colorectal carcinomas, the level of invasion can beclinically diagnosed, consequently endoscopic resection should be initially performed whenlesions are evaluated as sm1 prior to resection. When histological investigation reveals sm1carcinoma with histologic grade I (well-differentiated) or II (moderately-differentiated), andthe absence of lymphatic invasion and budding, endoscopic treatment alone is sufficient.
机译：我们调查了77例粘膜下浸润性结直肠癌病变的组织学因素与淋巴结转移之间的关系，以建立有用的标准病变，其中仅通过内窥镜治疗即可治愈恶性肿瘤。组织学因素之间存在正相关性，包括浸润程度，组织学等级，是否存在淋巴管浸润，是否存在出芽以及淋巴结转移（p <0.05，p <0.05，p <0.005，p <0.01）。 。静脉浸润的有无并不影响淋巴结转移。对于有组织学不利因素的sm1癌病灶，应进行​​腹腔镜手术，包括淋巴结清扫术;在切除前被诊断为sm2或sm3的病灶中，应直接进行经腹腔镜手术淋巴结清扫术的肠切除术，而无需在内窥镜下进行切除术。 ，可以通过临床诊断浸润水平，因此，在切除之前将病变评估为sm1时，应首先进行内镜切除。当组织学检查显示组织学级别为I（高度分化）或II（中度分化）且无淋巴管浸润和发芽的sm1癌时，仅内镜治疗就足够了。

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