383例食管癌患者淋巴结转移临床分析  

Analysis of lymph node metastasis from 383 esophageal cancer patients

作　　者：朱军[1] 郭业松[1] 杨丹[1] 钱普东[1] 查文武[1] 

机构地区：[1]江苏省肿瘤医院放射治疗科,南京210009

出　　处：《国际肿瘤学杂志》2007年第3期232-233,236,共3页Journal of International Oncology

摘　　要：目的了解食管癌淋巴结转移情况方法食管癌病例383例，男273例，女110例；颈段6例，胸上段58例，胸中段267例，胸下段52例。均行根治术，常规病理检查，统计其淋巴结转移情况及治疗情况。结果383例患者中148例显示淋巴结阳性，淋巴结转移率38．6％；共清扫淋巴结3317枚，阳性淋巴结349枚，淋巴结转移频度10．5％。按肿瘤对食管壁的浸润程度，不同的原发灶T分期间淋巴结转移频度差异有显著意义（P〈0．05）。按病变位置，食管中下段间淋巴结转移频度差异有显著意义（P=0．00）；按病理分级，Ⅱ、Ⅲ级间淋巴结转移频度差异有显著意义（P=0．02）；按X线显示的病变长度〈3cm、3～5cm、〉5cm组的淋巴结转移频度，前两者间差异无显著意义（P=0．145），后两者间差异有显著意义（P=0．00）。结论食管癌淋巴结转移频度与肿瘤在食管壁浸润深度及病变长度呈正相关，根椐术后淋巴结转移情况，术后放疗的价值和方法应重新研究。Objective To analyze the lymph nodes metastases of post esophagectomy patients. Methods Totally 383 patients were enrolled in the data pool, male 273 and female 110,6 patients in cervical esophagus and 58 in upper thoracic ,267 in mid-thoracic, 52 in lower thoracic, all patients underwent curative esophagectomy, and were routinely pathological examined. Their lymph nodes metastases and therapy condition were analyzed. Results 148 of the 383 patients had positive lymph nodes metastases, lymph nodes metastases rate was 38. 6% ,total number of positive lymph nodes was 349,3 317 lymph nodes were resected from those 383 patients;frequency of lymph node metastasis was 10. 5%. The frequencies of lymph nodes metastases of primary tumor in T stage had statistical difference （ P 〈 0. 05 ） ; There was a statistical difference in lymph nodes metastases frequencies between mid-and lower-thoracic esophagus （ P = 0. 00 ） ;and between pathologic grade Ⅱ and Ⅲ （ P =0. 02） ; frequencies of lymph nodes metastasis between the lesion length 〈3cm,3 ～ 5 cm, 〉 5cm group were measured （according to barium film） ,there was no statistical difference between the first two groups（ P = 0. 145 ）, meanwhile there was a statistical difference between the 3 ～ 5cm group and 〉 5cm group（ P =0. 00） . Conclusion The frequency of lymph nodes metastases is positively relative to the invaded depth and lesion length of esophagus, the value and exact method of postoperative radiotherapy of esophageal cancer should be reassessed according to the lymph nodes metastases.

关 键 词：食管肿瘤 外科手术 淋巴转移 

分 类 号：R735[医药卫生—肿瘤]