表浅食管鳞癌淋巴结转移规律探讨  

Risk Factors of Lymph Node Metastasis in Superficial Esophageal Squamous Cell Carcinoma

作　　者：苏畅[1,2] 朱林林[1] 冯丽[1] 郭天骄 甘涛[1] 杨锦林[1] 吴俊超[1] 王一平[1] 

机构地区：[1]四川大学华西医院消化内科,成都610041 [2]武警四川总队成都医院消化内科,成都610041

出　　处：《四川大学学报（医学版）》2015年第6期906-910,共5页Journal of Sichuan University(Medical Sciences)

基　　金：四川省科技厅科技支撑计划项目(No.2015SZ0123)资助

摘　　要：目的根据外科食管癌根治术后病理结果,分析表浅食管鳞癌淋巴结转移情况,预测T1期食管鳞癌淋巴结转移的可能性及内镜下治疗的可行性。方法回顾性分析344例行食管鳞癌根治术并经病理确诊的早期食管鳞癌患者的临床资料,比较有/无淋巴结转移早期食管鳞癌患者的临床病理特征,对其与淋巴结转移的相关性进行单因素、多因素分析,估计淋巴结转移的风险。结果单因素分析显示:肿瘤大小(P=0.004)、浸润深度(P=0.009)、分化程度(P=0.030)和淋巴管肿瘤浸润((P=0.002)与淋巴结转移有关;多因素分析结果显示肿瘤直径(P=0.007)、浸润深度(P=0.003)、分化程度(P<0.050)和淋巴管肿瘤侵润(P<0.001)为淋巴结转移的独立危险因素。结论肿瘤直径<3cm的高/中分化黏膜内鳞癌患者淋巴结转移风险小,有行内镜切除术的绝对适应证;肿瘤直径≥3cm的高、中、低分化黏膜内鳞癌患者淋巴结转移风险大,如行内镜切除术,需关注术后病理及随访。Objective To analysis the risk factors of lymph node metastasis（LNM）in superficial esophageal squamous cell carcinoma（SESCC）.Methods The clinical data and pathological results of 344 SESCC patients,who underwent surgical treatments between January 2009 and December 2013 in West China Hospital,Sichuan University, were analyzed retrospectively.Clinicopathologic characteristics were compared between different histological types,and their possible relationships with LNM were explored by univariate and multivariate analysis.Results There were no LNM found in the patients with tumor limited to the mucous,tumor diameter 3cm,highly and moderate differentiated SESCC.Univariate analysis showed that tumor diameter（P=0.004）,depth of tumor invasion（P=0.009）,histological type（P=0.030）and lymphatic involvement（P=0.002）were correlated with LNM.Multivariate analysis revealed that tumor diameter（P=0.007）,depth of tumor invasion（P=0.003）,histological type（P=0.010）and lymphatic involvement（P〈 0.001）were independent risk factors of LNM.Conclusion To the patients with low risk of LNM,such as tumor limited to the mucous,tumor diameter3cm,and highly and moderate differentiation,endoscopic excision may be considered as an absolute indications.

关 键 词：表浅食管癌 淋巴结转移 临床病理特征 

分 类 号：R735.1[医药卫生—肿瘤]