胸段食管鳞癌根治术后区域淋巴结的复发模式  

Patterns of regional lymph node recurrence after radical esophagectomy for thoracic esophageal squamous cell carcinoma

作　　者：戴明明[1] 吴三纲[1] 郑华[1] 陈珊宇[1] 李夷民[1] 邓翀[1] 周雨霏[1] 林勤[1] 

机构地区：[1]厦门大学附属第一医院放射治疗科,福建省厦门市361003

出　　处：《世界华人消化杂志》2014年第28期4237-4242,共6页World Chinese Journal of Digestology

摘　　要：目的:探讨胸段食管鳞癌根治术后区域淋巴结的复发模式.方法:回顾性分析2008-01/2012-12收治的114例行胸段食管癌根治术后出现区域淋巴结复发患者的临床资料.结果:114例患者中位复发时间8 mo,锁骨上区淋巴结(63例/114例)和腹腔淋巴结(44例/114例)为最常见的复发部位.胸上段和胸中段的锁骨上区淋巴结复发率显著高于胸下段患者(χ2=13.174,P=0.001),胸下段患者的腹腔淋巴结复发显著高于胸上段和胸中段患者(χ2=18.787,P<0.001),纵膈淋巴结的复发和食管发病部位无显著相关性.ⅢA-ⅢC期患者的腹腔淋巴结复发率显著高于ⅠB-ⅡB期的患者(χ2=5.279,P=0.022).腹腔淋巴结复发的患者更易于出现远处转移(χ2=5.026,P=0.025),特别是肝转移(χ2=8.628,P=0.003).结论:胸段食管鳞癌根治术后区域淋巴结的复发模式和肿瘤原发部位、肿瘤分期等相关,腹腔淋巴结复发患者更易出现远处转移.AIM： To investigate the patterns of regional lymph node recurrence after radical esophagec-tomy for thoracic esophageal squamous cell car-cinoma. METHODS： A retrospective analysis was per-formed of 114 patients with regional lymph node recurrence after radical esophagectomy for esophageal squamous cell carcinoma from Janu-ary 2008 to December 2012. RESULTS： The median recurrence time was 8 mo. The most common sites of relapse were supraclavicular lymph nodes（61/114） and ab-dominal lymph nodes（44/114）. The recurrence rate of supraclavicular lymph nodes in upperand middle thoracic carcinomas was significant-ly higher than that in lower thoracic carcinomas（χ2 = 13.174, P = 0.001）. The recurrence rate ofceliac lymph nodes in lower thoracic carcino-mas was significantly higher than that in upperand middle thoracic carcinomas（χ2 = 18.787, P〈 0.001）. There was no significant correlationbetween tumor location and lymph node recur-rence in the mediastinum. The recurrence rateof celiac lymph nodes in stage ⅢA-ⅢC diseasewas significantly higher than that in stage ⅠB-ⅡB（χ2 = 5.729, P = 0.022）. Patients with celiaclymph node recurrence were prone to distantmetastases（χ2 = 5.026, P = 0.025）, especially livermetastases（χ2 = 8.628, P = 0.003）. CONCLUSION： Patterns of regional lymphnodes recurrence after radical esophagectomyfor thoracic esophageal squamous cell carcino-ma are associated with primary tumor site andtumor stage. Patients with celiac lymph noderecurrence are more prone to distant metastases.

关 键 词：食管癌 手术治疗 局部区域复发 淋巴结 

分 类 号：R735.1[医药卫生—肿瘤]