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°áÀå ¹× Á÷Àå¾Ï ȯÀÚ¿¡ ÀÖ¾î º¹°­¾×ÀÇ ÀÇ¹Ì The Significance of Peritoneal Effusion in Colorectal Cancer

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ÀÌÀαÔ, ÀÌÁ¤¹Î, ÀÌÀ±¼®, ±èÇüÁø, ¹ÚÁ¾°æ, ¿À½ÂÅÃ, ±èÁرâ, ÀüÇظí, Àå¼®±Õ,
¼Ò¼Ó »ó¼¼Á¤º¸
ÀÌÀαԠ( Lee In-Kyu ) 
°¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç

ÀÌÁ¤¹Î ( Lee Jung-Min ) 
°¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç
ÀÌÀ±¼® ( Lee Yoon-Suk ) 
°¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç
±èÇüÁø ( Kim Hyung Jin ) 
°¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç
¹ÚÁ¾°æ ( Park Jong-Kyung ) 
°¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç
¿À½ÂÅà( Oh Seung-Tack ) 
°¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç
±èÁرâ ( Kim Jun-Gi ) 
°¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç
ÀüÇظí ( Jeon Hae-Myung ) 
°¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç
Àå¼®±Õ ( Chang Suk-Kyun ) 
°¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç

Abstract


Purpose: It has been reported that in colorectal cancer, the positive rate of the cytological examination of ascites is low and that the cytologically positive result of the cancer cell influences its prognosis; nonetheless, not many studies on the correlation of the formation of peritoneal effusion and cancer have been done yet. Thus, this study on the correlation of clinico-pathological findings with peritoneal effusion was initiated.

Methods: The study population, includes a total of 191 patients who underwent an operation for colon cancer and rectal cancer from May 1, 2004, to December 31, 2005. Peritoneal effusion considered to be present in cases with more than 10 cc of body fluid retained in the Douglas pouch, and a cytological test was performed on patients whose retained fluid was more than 50 cc. In all patients, the correlation of the clinico-pathological findings with peritoneal effusion was analyzed, and the volume of effusion and the positive result of peritoneal cytology were compared.

Results: Among the 191 patients, patients without peritoneal effusion numbered 133 (69.6%) and patients with peritoneal effusion numbered 58 (30.4%). Between the two groups, the presence of intestinal obstruction due to cancer (P£¼0.001), perineural involvement (P=0.025), lymph node metastasis (P=0.004), lymph- node stage (P=0.001), distal metastasis (P=0.012), macroscopic peritoneal dissemination, and stage (P=0.017) were statistically significantly different. In the multivariate analysis, only the presence of intestinal obstruction and lymph-node disease stage correlated statistically significantly to the formation of peritoneal effusion (P=0.009, 0.004). Twenty patients (34.5%) had peritoneal effusion of more than 50 cc, and among them, malignant cells were detected in 3 patients (15%). Based on 50-cc peritoneal effusion, more or less effusion and the detection of malignant cells by peritoneal cytology did not correlate with the clinico- pathological outcomes (P£¾0.05).

Conclusions: For colorectal cancer patients with peritoneal effusion, but without co-morbid medical diseases inducing such peritoneal effusion, by regarding peritoneal effusion itself as meaningful, the range of lymphadenectomies, adjuvant chemotherapy, and other additional therapy should be considered. J Korean Soc Coloproctol 2006;22:308-313

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Peritoneal effusion;Colorectal cancer;Cytology

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