淋巴结状态对食管癌术后生存的影响分析  

Impact of lymph node status on prognosis in patients with esophageal cancer after curative resection

作　　者：朱青山[1,2] 刘明勋[1,2] 申静[1,2] 何志杰[1,2] 魏涛[1,2] 王景花[1,2] 

机构地区：[1]河南科技大学第四附属医院 [2]安阳市肿瘤医院肿瘤科,河南安阳455000

出　　处：《中国现代医学杂志》2012年第15期62-66,共5页China Journal of Modern Medicine

摘　　要：目的探讨食管癌根治术后淋巴结状态对预后的影响。方法回顾性分析2004年1月～2008年3月在该院经胸行食管癌根治术,并且有随访资料的1 006例患者,分析术后淋巴结状态,应用SPSS软件,采用Kaplan-Meier方法进行生存分析,评估淋巴结状态与生存期的关系。结果全组共检出淋巴结9 794个,转移淋巴结1 283个,总体转移度0.13;1 006例患者总体淋巴结转移率为44.4%,平均每例检出淋巴结数目为10.2个。全组术后1、3、5年生存率分别为93.9%、74.5%和55.9%。中位生存时间为82.0个月(95%CI 51.5～112.5)。影响预后的淋巴结状态为淋巴结清扫数目(负相关P=0.03),淋巴结转移数目(P=0.00),转移淋巴结区数(P=0.00),和淋巴结转移度无明显相关(P=0.33)。结论影响经胸食管癌切除术后预后的主要因素之一是淋巴结转移,淋巴结转移数目明显影响食管癌的预后,2009年第7版的AJCC分期中基于淋巴结转移数目的新法N分期标准能更好地反映食管癌切除术后患者预后的变化;过度的淋巴结清扫无助于改善预后。【Objective】 To investigate the impact of lymph node status on esophageal squamous cell carcinoma after curative resection and evaluate the new seventh edition of the tumor-node-metastasis classification by American Joint Cancer Committee（AJCC） for esophageal cancers.【Methods】 We retrospectively reviewed data for 1006 patients who underwent curative esophagectomy for esophageal squamous cell carcinoma from January 2004 to March 2008.The lymph node status and survival data were examined.The software of SPSS 13.0 and Kaplan-Meier analysis was used as statistical methods.【Results】 The total resected lymph nodes were 9794 and the positive lymph nodes were 1283.The lymph node ratio and lymph node metastasis rate was 0.13 and 44.4% respectively.The mean numbers of resected lymph nodes for each case were 10.2.The median OS was 82 months（95% CI 51.5～112.5） and the 1,3,5-year survival rates were 93.9%,74.5% and 55.9% respectively.Our retrospective study showed number of resected lymph nodes（P =0.03）,number of lymph node metastases（P =0.00） and involved lymph node field（P =0.00） are associated with poor prognosis,but lymph node ratio was not prognostic factor（P =0.33.【Conclusion】 The new seventh edition of the tumor-node-metastasis classification improved the predictive ability for cancers of the esophageal;Over lymphadenectomy could not improve the OS for patients with esophagectomy.

关 键 词：食管癌 淋巴结 预后 

分 类 号：R735.1[医药卫生—肿瘤]