胸段食管鳞癌肝总淋巴结清扫的策略  被引量:3

Discussion on the strategies of common hepatic artery lymph node dissection for thoracic esophageal squa- mous cell carcinoma

在线阅读下载全文

作  者:马晓[1] 李斌[1] 杨溯[2] 李鹤成[1] 张亚伟[1] 相加庆[1] 陈海泉[1] 

机构地区:[1]复旦大学附属肿瘤医院胸外科、复旦大学上海医学院肿瘤学系,上海200032 [2]南京市胸科医院胸外科,210029

出  处:《中华消化外科杂志》2013年第10期774-778,共5页Chinese Journal of Digestive Surgery

基  金:国家自然科学基金(81272608);上海市科技启明星跟踪计划(11QH1400600)

摘  要:目的分析胸段食管鳞癌中肝总淋巴结转移规律,探讨肝总淋巴结清扫的策略。方法回顾性分析2005年5月至2010年12月复旦大学附属肿瘤医院收治的682例食管鳞癌患者的临床资料。分析胸段食管鳞癌区域淋巴结转移情况、肝总淋巴结转移率与临床病理因素的关系及患者术后近期并发症发生情况。计数资料采用x2检验。结果682例胸段食管鳞癌患者共清扫淋巴结18277枚,平均清扫27枚/例,淋巴结转移率为55.87%(381/682),淋巴结转移度为7.87%(1438/18277)。在所有清扫的淋巴结中,贲门旁淋巴结、喉返神经旁淋巴结、胃小弯淋巴结、颈段食管旁淋巴结、胃左动脉旁淋巴结转移率较高,而肝总淋巴结转移率最低,并且无单独肝总淋巴结转移,全部伴有区域淋巴结转移。682例患者共清扫肝总淋巴结1480枚,平均清扫2枚/例。24例患者发生肝总淋巴结转移,淋巴结转移率为3.52%(24/682),淋巴结转移度为2.16%(32/1480)。胸上、中、下段食管鳞癌肝总淋巴结转移率分别为2.33%(1/43)、3.76%(16/425)、3.27%(7/214),3者比较,差异无统计学意义(x^2=0.295,P〉0.05);T1、T2、T3期患者的肝总淋巴结转移率分别为2.35%(2/85)、5.46%(10/183)、2.90%(12/414),3者比较,差异无统计学意义(x^2=2.850,P〉0.05);高、中、低分化食管鳞癌患者肝总淋巴结转移率分别为0(0/63)、3.50%(16/457)、4.94%(8/162),3者比较,差异无统计学意义(x^2=3.259,P〉0.05);肿瘤直径≤3em、〉3CA且≤5cm、〉5cm的患者肝总淋巴结转移率分别为2.59%(6/232)、3.02%(11/364)、8.14%(7/86),3者比较,差异有统计学意义(X^2=6.267,P〈0.05);N分期中N0、N1、N2、N3期患者的肝总淋巴结转移率分别为0(0/301)、2.53%(Objective To analyze the metastatic rule of common hepatic artery lymph node of thoracic esophageal squamous cell carcinoma, and to investigate the strategies of common hepatic artery lymph node dissec tion. Methods The clinical data of 682 patients with esophageal squamous cell carcinoma who were admitted to the Cancer Hospital of Fudan University from May 2005 to December 2010 were retrospectively analyzed. The locoregional lymph node metastasis of thoracic esophageal squamous cell carcinoma, relationship between metastatic rates of common hepatic artery lymph node and clinicopathological factors and the postoperative complications were analyzed. The enumeration data were analyzed using the chi-square test. Results A total of 18 277 lymph nodes were dissected (27 lymph nodes per patient). The lymph node metastatic rate was 55.87% (381/682), and themetastatic lymph node ratio was 7.87% ( 1438/18 277). Lymph nodes adjacent to the cardia of stomach, laryngeal nerve, lesser curvature of stomach, cervical esophagus, left gastric artery had a higher metastatic rate, while com mon hepatic artery lymph node had a lower metastatic rate. All the common hepatic artery lymph node metastasis was accompanied with locoregional metastasis. A total of 1480 common hepatic artery lymph nodes were dissected (2 common hepatic artery lymph nodes per patient). Twenty-four patients had common hepatic artery lymph node metastasis, with the metastatic rate of 3.52% (24/682) and the lymph node ratio of 2. 16% (32/1480). The common hepatic artery lymph node metastatic rates of upper, middle and lower esophageal squamous cell carcinoma were 2.33% (1/43), 3.76% (16/425) and 3.27% (7/217), with no significant difference (X2 = 0. 295, P 〉 0.05 ). The common hepatic artery lymph node metastatic rates of patients in T1, T2 and T3 stages were 2.35% (2/85) , 5.46% ( 10/183 ) and 2.90% ( 12/414), with no significant difference (X2 = 2. 850, P 〉 0.05 ). The common hepatic artery lymph node

关 键 词:食管肿瘤 肝总淋巴结 淋巴结清扫 

分 类 号:R735.1[医药卫生—肿瘤]

 

参考文献:

正在载入数据...

 

二级参考文献:

正在载入数据...

 

耦合文献:

正在载入数据...

 

引证文献:

正在载入数据...

 

二级引证文献:

正在载入数据...

 

同被引文献:

正在载入数据...

 

相关期刊文献:

正在载入数据...

相关的主题
相关的作者对象
相关的机构对象