부산대학교 도서관

Eighty patients who underwent curative resection of rectal carcinoma were studied to determine the prognostic value of tumor biological attitude in metastasized lymph nodes (LN) and the host response in non-involved LN. Patients with budding (bd) and/or extracapsular spread (ext-cap) in metastasized LN (AT (+)) showed a worse survival curve than patients without bd or ext-cap (AT (-)) (p<0.001). AT (+) patients had higher overall and local recurrence rates than AT (-) patients (p<0.001, p<0.01, respectively). The patients with two or three high grade responses of paracortical hyperplasia, germinal center hyperplasia, and sinus histiocytosis in non-involved LN (NA (+)) showed better survival curves than those with only one high grade response or none (NA (-)) (p<0.05). The patients with larger non-involved LN also showed a better survival curve than those with smaller ones (p<0.01). NA (+) patients showed a significantly lower incidence of AT (+) than NA (-) patients (p<0.05). It was indicated that bd and ext-cap in metastasized LN represented a vigorous biological attitude of the tumor and that the response in non-involved LN represented the host response to the tumor. Therefore, both tumor biological attitude in metastasized LN and host response in non-involved LN were thought to have prognostic value for rectal cancer.