全胸段食管切除术纵隔淋巴结转移度的临床研究  

Clinical study on mediastinal lymph node metastatic rate of en bloc esophagectomy

作　　者：庞作良[1] 孙伟[1] 张国庆[1] 斯刊达尔.阿布力孜 高胜利[1] 阿迪利.萨来 毛拉.艾沙[1] 

机构地区：[1]新疆医科大学附属肿瘤医院胸外科,乌鲁木齐830011

出　　处：《中国肿瘤临床与康复》2004年第6期488-490,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的　从淋巴结转移度的角度探讨胸段食管癌全胸段食管切除术纵隔淋巴结转移的规律。方法　对 86例食管癌合并纵隔淋巴结转移者实施全胸段食管切除术的临床资料进行回顾性分析。结果　全组 86例胸段食管癌共检出淋巴结 180 6枚 ,平均每例清除淋巴结 (18± 4 .6 )枚 (15～ 30枚 )。转移淋巴结 2 5 3枚 ,淋巴结转移度 14 .0 % (2 5 3 180 6 )。中纵隔淋巴结转移度与上、下纵隔淋巴结转移度相比 ,差异有显著性 (P <0 .0 1) ;食管癌病变部位与上、中、下纵隔淋巴结转移度无显著相关 (P<0 .0 1) ;术后病理T分期与纵隔淋巴结转移度有显著相关 (P <0 .0 0 1)。食管癌病变长度与上、中、下纵隔淋巴结转移度无显著相关 (P =0 .2 0 3)。食管癌病变部位与纵隔淋巴结“跳跃性”转移无显著相关 (P =0 .933)。结论　胸段食管癌纵隔淋巴结呈“双向性”转移 ,纵隔不同区域的淋巴结转移度与肿瘤的部位、T分期有关 ,对于食管癌病变引流区域的淋巴结均应进行严格清扫。Objective To study the mediastinal lymph node metastasis rate(LMR) of thoracic esophageal carcinoma treated with removal of total thoracic esophageal tube and extensive resection of regional lymph nodes and soft tissue.Methods Eighty-six patients with thoracic esophageal squamous-cell carcinoma and mediastinal lymph node metastasis who underwent en bloc esophagectomy were analysed retrospectively.Results 1806 lymph nodes were dissected with an average of 18±4.6(15-30)lymph nodes in each case. 253 lymph nodes had metastasis and the mediastinal LMR was 14.0%(253/1806). LMR was statistically different between middle and upper,lower mediastinum(P<0.01).The site of thoracic esophageal carcinoma was correlated to upper,middle,and lower mediastinal LMR(P<0.01).Statistical correlation was found between postoperative T-staging and mediastinal LMR(P<0.01).There was no statistical correlation between the length of lesion and LMR(P=0.203) and between the site of thoracic esophageal carcinoma and “jumping” mediastinal lymph node metastasis(P=0.933).Conclusions LMR of thoracic esophageal carcinoma showed bidirectional metastasis,different regional LMR of mediastinum correlated to the site of lesion and postoperative T-staging.The regional mediastinal lymphnode draining thoracic esophageal carcinoma should be dissected strictly.

关 键 词：食管肿瘤 食管切除术 纵隔淋巴结转移度 

分 类 号：R735.1[医药卫生—肿瘤] R730.56[医药卫生—临床医学]