食管癌不同部位淋巴结大小与转移的关系  

Relationship between the size and location of lymph nodes and metastatic infiltration in esophageal carcinoma

作　　者：方卫民[1] 朱坤寿[1] 

机构地区：[1]福建省肿瘤医院胸外科,福州350014

出　　处：《肿瘤研究与临床》2007年第4期237-238,240,共3页Cancer Research and Clinic

摘　　要：目的评估食管癌不同部位淋巴结大小与转移的相关性。方法对行三野根治术的156例食管癌患者所清扫的淋巴结,按部位及大小分组,并与病理组织学结果进行比较分析。结果156例患者共清扫淋巴结3838枚,颈部、上纵隔、中纵隔、下纵隔及胃周分别占25.0%、16.7%、21.0%、12.2%和25.1%。组织学检查证实转移583枚,颈部、上纵隔、中纵隔、下纵隔及胃周淋巴结转移率分别为25.2%、23.4%、8.6%、12.0%和6.9%。除下纵隔外,其余部位淋巴结大小>15 mm、10～15 mm、<10 mm的三组之间的转移率差异有统计学意义(均为P<0.01)。以淋巴结大小作为判定转移的标准,在不同部位中,诊断的敏感性和特异性相近,但颈部及上纵隔的阳性预示值明显高于其他部位。结论食管癌淋巴结大小与转移呈一定相关性,但诊断率较低。临床应用中,应根据部位区别对待。Objective To evaluate the relationship between the size and the location of lymph nodes and metastatic infiltration in esophageal carcinoma.Methods The regional lymph nodes acquired by radical three-field lymphadenectomy from 156 patients with esophageal carcinoma were analyzed.The lymph nodes were counted and the largest diameter of each lymph node was measured and analyzed for metastatic involve- ment by histological examination.Results A total of 3838 lymph nodes were present in all cases.It covered 25.0 %,16.7 %,21.0 %,12.2 % and 25.1% in cervical region,upper mediastinum,middle mediastinum, lower mediastinum and perigastric region respectively.583 lymph nodes showed metastatic involvement on histopathologic examination.The lymph node metastasis ratio in cervical region,upper mediastinum,middle mediastinum,lower mediastinum and perigastric region were 25.2 %,23.4 %,8.6 %,12.0 % and 6.9 %,re- spectively.Except in lower mediastinum,the differences among the metastasis ratio of the lymph nodes whose diameters were>15 mm,10～15 mm,<10 mm are significant(P<0.01).The sensitivities and specificities were similar when the size of lymph node was used as a criteria of metastases in different region,but the posi- tive predication index in cervical region and upper mediastinum are much higher than those in the other re- gions.Conclusion There are some relativity between the size of lymph node and metastatic infiltration,but its diagnosis efficiency is lower.It should be operated according to different regions in clinical applications.

关 键 词：食管肿瘤 淋巴结 淋巴转移 

分 类 号：R735.1[医药卫生—肿瘤]