胸段食管癌三野根治术后淋巴结转移分析及放疗靶区探讨  

Study of lymph node metastasis and target delineation of thoracic esophageal cancer after three-field esophagectomy

作　　者：蒋华勇[1] 王雅棣[1] 许卫东[1] 张富利[1] 

机构地区：[1]北京军区总医院放疗科,北京100700

出　　处：《现代肿瘤医学》2014年第7期1594-1596,共3页Journal of Modern Oncology

摘　　要：目的:总结胸段食管癌三野淋巴结清扫食管癌根治术后的区域淋巴结病理检查结果,分析转移规律,指导术后放疗靶区设计。方法:回顾我院确诊的行颈、胸、腹三野根治术的76例胸段食管癌患者,按肿瘤部位分为胸上段,胸中段和胸下段,分析各段食管癌的淋巴结转移情况,探讨区域淋巴结转移规律。结果:胸上段食管癌淋巴结转移主要在下颈、锁骨上和上纵隔,腹部淋巴结转移少见;胸中段食管癌淋巴结转移主要出现在下颈、锁骨上和上、中纵隔;胸下段食管癌淋巴结转移主要出现在中、下纵隔和上腹部。结论:胸段各部位食管癌淋巴结转移倾向性不同,术后放疗靶区设计宜分别考虑区域淋巴结引流区,合理设计,避免不必要的大野照射。Objective：To summarize pathologic outcome of regional lymph nodes of patients treated with three - field lymphadenectomy in esophageal squamous cell carcinoma（ESCC） and the characteristics of metastasis to guide target designation of radiotherapy. Methods：Seventy - six patients of upper, middle and lower thoracic ESCC treated with three -field lymphadenectomy were retrospectively evaluated. The metastasis features of the lymph nodes were analyzed. Results： For the upper thoracic ESCC, the metastasis of the lymph nodes mostly occurred at the lower cervi- cal, supraclavical, upper and middle mediastatic sites while scarcely at the abdominal site. For the middle thoracic ES- CC, the metastasis of the lymph nodes usually occurred at the lower cervical, supraclavical, upper and middle media- static sites. For the lower thoracic ESCC, the metastasis of the lymph nodes mainly occurred at the middle,lower medi- astatic and uppei abdominal sites. Conclusion：The metastasis tendency of ESCC of different thoracic regions are dif- ferent. Attention should be paid to different lymphatic drainage region to avoid unnecessary large field irradiation.

关 键 词：胸段食管癌 三野根治术 淋巴结转移规律 放疗靶区 

分 类 号：R735.1[医药卫生—肿瘤]