食管癌转移淋巴结外科治疗的研究进展  

Research Progress on Surgical Treatmet for Lymph node Metastases from Oesophageal Cancer

作　　者：武韫[1] 吕帆真[1] 朱正洪[1] 毕磊[1] 张立凡[1] 沈晓咏[1] 杨敏杰[1] 张辉标[1] 陆英杰[1] 

机构地区：[1]复旦大学附属华东医院胸外科,上海200040

出　　处：《现代生物医学进展》2013年第19期3798-3800,共3页Progress in Modern Biomedicine

摘　　要：食管癌早期即具有跳跃式淋巴结转移的特点,中下段食管癌喉返神经累及可作为颈部淋巴结转移的预测因子。淋巴结转移是影响食管癌预后的重要因素。食管癌术前应详细评估有无淋巴结转移,术中应尽可能广泛切除病变组织。常见的手术路径包括经胸及经食道裂孔两种方式,但由于不能有效清扫纵隔淋巴结,因此经食道裂孔食道切除术应该严格把握手术适应症。三野淋巴结清扫适用于中上段食管癌,二野淋巴结清扫结合术后新辅助治疗可取得较满意的生存率。本文主要就食管癌转移淋巴结外科治疗的研究进展做一综述,旨在为改善食管癌的预后提供更多的参考依据。Oesophageal cancer（OC） is the most common cause of cancer-related death in the world.Skip metastasis is a common form of lymphatic spread in early stage of esophageal cancer. Metastasis to Recurrent Laryngeal Lymph Node is a reliable indicator of cervical 1）~nph node metastasis in middle/lower thoracic esophageal cancer. Lymph node involvement is the single most important prog- nostic factor for oesophageal cancer. A combination of EUS, CT and PET should be used in preoperative staging to avoid under-staging oesophageal cancer and plan optimal treatment. Trans-thoracic esophagectomy （TTE） and Trans-hiatal oesophagectomy （THE） are two common surgical approaches for Oesophagel Cancer. Though THE and TTE has no difference in 5-year survival,but TTE is more often for advanced cancer. The fmding of equivalent survival should be therefore viewed with caution. Radical transthoracic oesophagectomy with two-field lymphadenectomy appears to offer an optimal balance between benefits and risks to a majority of OC patients, especially in the growing area of neoadjuvant treatments. 3-field lymphadenectomy may be reserved to selected patients with loco-regional disease, surely for patients with upper OC. This article mainly reviewed the research progress on surgical treatmet for lymph node metastases from oesophageal cancer, in order to provide more references for the improvement of prognosis of oesophageal cancer.

关 键 词：食管癌 淋巴结转移 外科手术 预后 研究进展 

分 类 号：R735.1[医药卫生—肿瘤]