Lymph node metastases are common in pelvic urological tumors, and the age-related remodeling process of the pelvic lymph nodes influences metastatic behavior. The aim of this work is to characterize age-related degenerative changes in the pelvic lymph nodes with respect to their occurrence and extent. A total of 5173 pelvic lymph nodes of 390 patients aged 44 to 79 years (median 68 years, IQR 62–71 years) were histologically examined for degenerative structural changes. Lymph node size, lipomatous atrophy, capsular fibrosis, framework fibrosis, and calcifications were recorded semi-quantitatively and evaluated by age group. Significantly more lymph nodes <10 mm were found in older patients (p= 0.001). The incidence of framework fibrosis, capsular fibrosis, and calcifications increased significantly with increasing patient age (p< 0.001). In lipomatous atrophy, an increase in mild to moderate lipomatous atrophy was observed with increasing age (p< 0.001). In this, the largest study to date on this topic, age-related degenerative changes in pelvic lymph nodes were proven. Due to the consecutive decrease in hte filtration function of pelvic lymph nodes with increasing age, staging and therapy of metastatic pelvic urologic carcinomas should be reconsidered.
淋巴结转移在盆腔泌尿系统肿瘤中较为常见，盆腔淋巴结与年龄相关的重塑过程会影响其转移行为。本研究旨在从发生率和程度两方面描述盆腔淋巴结与年龄相关的退行性改变特征。我们对390例年龄在44至79岁（中位年龄68岁，四分位距62-71岁）患者的5173枚盆腔淋巴结进行了组织学检查，以评估其退行性结构变化。采用半定量方法记录淋巴结大小、脂肪萎缩、被膜纤维化、框架纤维化及钙化情况，并按年龄组进行分析评估。结果显示，老年患者中直径<10毫米的淋巴结显著增多（p=0.001）。随着患者年龄增长，框架纤维化、被膜纤维化和钙化的发生率显著上升（p<0.001）。在脂肪萎缩方面，轻度至中度脂肪萎缩随年龄增长而增加（p<0.001）。作为该领域迄今规模最大的研究，本研究证实了盆腔淋巴结存在与年龄相关的退行性改变。鉴于盆腔淋巴结滤过功能随年龄增长而持续下降，对于转移性盆腔泌尿系统癌的分期和治疗策略应重新评估。
肿瘤(癌症)患者之家