胸段食管鳞癌淋巴结转移规律的临床研究  

Clinical study of lymph node metastatic pattern of thoracic esophageal squamous carcinoma

作　　者：谢映涛[1] 王树钦[1] 左强[2] 黄金球[1] 安丰山[1] 陈少湖[1] 罗荣城[2] 

机构地区：[1]广东省食管肿瘤科研中心,广东省揭阳市人民医院肿瘤外科,广东广州522000 [2]南方医科大学南方医院肿瘤中心,广东广州510515

出　　处：《第一军医大学学报》2005年第5期573-574,共2页Journal of First Military Medical University

摘　　要：目的分析胸段食管癌淋巴结转移规律,探讨合理的淋巴结清扫范围。方法对217例经“三区域”淋巴结清除根治术的食管癌患者的临床资料进行回顾性分析。结果全组淋巴结转移率62.6%,转移度11.38%,淋巴结“跳跃性转移”率为5.5%。胸上、中、下段食管癌颈部、胸部和腹腔淋巴结转移率分别达到31.7%、21.9%、9.75%,21.2%、30.5%、12.7%和12.1%、15.6%、34.5%。影响淋巴结转移的因素为肿瘤浸润深度、分化程度及有无淋巴管浸润(P<0.05)。结论胸段食管癌表现出上下“双向性”转移和跳跃性转移的特点,对胸段食管癌尤其是胸上、中段食管癌在条件具备时应施行“三区域”淋巴结清扫术,以提高患者的5年生存率。Objective To analyze the patterns of lymph node metastases of thoracic esophageal carcinoma and define the adequate range of lymph node dissection. Methods The clinical data of 217 patients with esophageal carcinoma undergoing radical surgical resection of the lymph nodes in three regions were retrospectively analyzed. Results Lymph node metastases were found in 136 of the 217 patients (62.6%) and skip metastases of the lymph nodes in 12 patients (5.5%). In 3 989 lymph nodes desected, metastases were identified in 454 lymph nodes (11.38%). The rates of lymph node metastasis were 31.7%, 21.2% and 12.1% in the neck, thoracic mediastinum and abdominal cavity, respectively, in upper thoracic esophageal carcinoma, 21.9%, 30.5% and 15.6% in middle thoracic carcinoma, and 9.75%, 12.7% and 34.5% in lower thoracic carcinoma. The degree of tumor differentiation, depth of tumor invasion and lymphatic vessel invasion were factors influencing lymph node metastases (P<0.05). Conclusion Because of the upward, downward and skip metastasis of esophageal carcinoma cells to the lymph nodes, the operable patients with thoracic esophagus carcinoma should receive radical desection of the lymph nodes in the 3 regions to promote the patients' survival.

关 键 词：淋巴结转移规律 胸段食管鳞癌 临床研究 淋巴结转移率 胸段食管癌 肿瘤浸润深度 淋巴结清扫术 回顾性分析 淋巴结清除 下段食管癌 淋巴管浸润 中段食管癌 5年生存率 临床资料 分化程度 跳跃性 癌患者 根治术 转移度 双向性 

分 类 号：R735.1[医药卫生—肿瘤]