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中华结直肠疾病电子杂志

中华结直肠疾病电子杂志 ›› 2023, Vol. 12 ›› Issue (03) : 234 -240. doi: 10.3877/cma.j.issn.2095-3224.2023.03.010

综述

结直肠癌淋巴结检出数目影响因素分析及个体化评估展望
焦帅, 关旭†(), 王锡山†()   
  1. 150006　哈尔滨，哈尔滨医科大学附属第二医院结直肠肿瘤外科
    100021　北京，国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院结直肠外科
    150006　哈尔滨，哈尔滨医科大学附属第二医院结直肠肿瘤外科；100021　北京，国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院结直肠外科
  • 收稿日期:2022-11-02 出版日期:2023-06-25
  • 通信作者: 关旭, 王锡山
  • 基金资助:
    科技部“常见多发病防治研究”重点专项青年科学家项目(2022YFC2505700)

Factor analysis and the prospect of individualized evaluation for lymph node harvest in colorectal cancer

Shuai Jiao, Xu Guan†(), Xishan Wang†()   

  1. Department of Colorectal Cancer Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150006, China
    Department of Colorectal Surgery, National Cancer Center, National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
    Department of Colorectal Cancer Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150006, China; Department of Colorectal Surgery, National Cancer Center, National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
  • Received:2022-11-02 Published:2023-06-25
  • Corresponding author: Xu Guan, Xishan Wang
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焦帅, 关旭, 王锡山. 结直肠癌淋巴结检出数目影响因素分析及个体化评估展望[J]. 中华结直肠疾病电子杂志, 2023, 12(03): 234-240.

Shuai Jiao, Xu Guan, Xishan Wang. Factor analysis and the prospect of individualized evaluation for lymph node harvest in colorectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(03): 234-240.

近年来，结直肠癌发病率及病死率不断上升，以手术为主的综合治疗策略是结直肠癌的主要治疗模式。结直肠癌术后淋巴结检出数目是评估外科手术质量和实现肿瘤精准分期的必要保障和前提，也对患者后续治疗决策有重要的临床意义。大量研究表明淋巴结检出数目受到整体治疗策略、手术切除方式、病理检出技术、患者个体差异及肿瘤异质性等多种因素影响，这也导致临床指南中要求“至少检出12枚淋巴结”的要求受到越来越多的争议。基于此现状，淋巴结个体化检出相关研究已成为该领域热点话题，这也是有望确保淋巴结检出具有科学性的重要手段和发展趋势。目前，多组学数据应用与人工智能分析等前沿技术也逐渐应用到淋巴结个体化检出的探索中，并取得了一定临床成果，但多数研究成果尚待转化。因此，我们也期待未来有更多高质量临床研究来探索淋巴结的个体化检出，从而更好完善临床分期和指导治疗及判定预后。

关键词: 结直肠肿瘤, 淋巴结检出, 肿瘤分期, 预后

In recent years, the morbidity and mortality of colorectal cancer have been increasing, and the comprehensive treatment strategy based on surgery is the main treatment mode of colorectal cancer. The number of lymph nodes detected after colorectal cancer surgery is a necessary guarantee and prerequisite for evaluating the quality of surgery and achieving accurate tumor staging, and it also has important clinical significance for patients' follow-up treatment decisions. A large number of studies have shown that the number of lymph nodes detected is affected by various factors such as the overall treatment strategy, surgical resection, pathological detection techniques, individual differences in patients, and tumor heterogeneity. This has also led to increasing controversy over the requirement of "at least 12 lymph nodes to be harvested" in clinical guidelines. Based on this situation, the research on individualized detection of lymph nodes has become a hot topic in this field, which is also an important means and development trend that is expected to ensure the scientificity of lymph node detection. At present, cutting-edge technologies such as multi-omics data application and artificial intelligence analysis have also been gradually applied to the exploration of individualized detection of lymph nodes, and certain clinical results have been achieved, but most of the research results have yet to be transformed. Therefore, we also look forward to more high-quality clinical studies in the future to explore the individualized detection of lymph nodes, so as to better improve clinical staging, guide treatment and determine prognosis.

Key words: Colorectal neoplasms, Lymph node harvest, Tumor staging, Prognosis
图1 淋巴结检出数目的影响因素
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