ปัจจัยที่สัมพันธ์กับการลุกลามของเซลล์มะเร็งเข้าสู่ต่อมน้ำเหลืองในมะเร็งลำไส้ใหญ่และไส้ตรงระยะ T1, T2

Abstract

The aim of this study was to determine factors correlated to lymph node metastasis of T1 and T2 colorectal cancer. Methods: Authors reviewed the medical records of T1 and T2 colorectal cancer patients who had been operated at Department of Surgery Phramongkutklao Hospital between 1999 and 2005. To determine factors related to lymph node metastasis. The demographical and pathological data had been analyzed comparing between patients with lymph node involvement (N1-2) and patients without lymph node involvement (N0). Results: The total number of 484 patients with colorectal cancers. There were sixty-eight T1 patients (14.05%) forty  (58.8%) were male twenty-eight (41.2%) were female with a mean age of 64.5 (range 18-86) years. The total numbers of 35 patients who eligible for this study. There were seven T1 patients (20%) and twenty-eight T2 patients  (80%). Three out of seven T1 patients (42.9%) had lymph node metastasis meanwhile thirteen out of twenty-eight T2 patients (46.4%) had lymph node metastasis. Lymphovascular invasion was found to be the only factor that enhanced the chance of lymph node metastasis. The odds ratio for lymphovascular invasion was elevated (10.8, 95% CI, 1.134-102.85) with statistical significance at p-value = 0.032. Conclusion: Evidence of lymphovascular  invasion detected from surgical specimens may enhance the chance of lymph node involvement of  T1 or T2 colorectal cancer patients. Adjuvant treatment should be provided for T1 or T2 patients with evidence of lymphovascular invasion especially the cases that less than 12 lymph nodes had been detected from surgical specimens.