食管癌淋巴结转移规律及预测模型研究进展  

Lymph node metastasis and predictive model in esophageal carcinoma

作　　者：范博士 宋伟安[1] 龚太乾 Fan Boshi;Song Weian;Gong Taiqian(Department of Thoracic Surgery, the Sixth Medical Center,Chinese PLA General Hospital,Beijing 100048,China)

机构地区：[1]解放军总医院第六医学中心胸外科,北京100048

出　　处：《中华腔镜外科杂志（电子版）》2020年第3期188-192,共5页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

基　　金：国家自然科学基金面上项目(81372556);国家自然科学基金青年基金(81902433);北京市自然科学基金资助项目(7204313);解放军总医院医疗大数据及人工智能研发项目(2019MBD-027)。

摘　　要：食管的淋巴管网丰富,引流范围广泛,涉及颈、胸和腹等处20余组淋巴结。淋巴结转移状态也是确定食管癌分期的重要指标,是判断患者预后的独立因子。手术依然是食管癌治疗最重要的方式之一。然而,目前关于食管癌淋巴结转移规律和食管癌淋巴结清扫范围依然缺乏统一的认识。选择性三野淋巴结清扫似乎更符合个性化医疗和精准医疗的时代潮流,但由于影像学诊断颈部淋巴结转移的灵敏性和特异性不足,选择性三野淋巴结清扫仍需高质量的临床证据验证。基于大数据的数学建模和影像组学已辅助用于疾病的临床诊断、治疗和预后的临床抉择,对其深入的研究及发展将有助于食管癌相关的诊断和治疗。The esophagus has a rich lymphatic network which covers a wide drainage area including more than 20 groups of lymph nodes in the neck,chest,and abdomen.Lymph node metastasis is an important descriptor to determine the stage of esophageal cancer,and correlates independently with the poor prognosis of patients.Surgery is still one of the most important treatments for esophageal cancer.However,there is still no unified consensus on the patterns of lymph nodes metastasis and extent of lymphadenectomy for esophageal cancer.Selective three-field lymphadenectomy seems to be a good choice and is consistent with the trend of personalized medicine.However,due to low sensitivity and specificity in imaging diagnosis of cervical metastatic lymph nodes,the efficacy of selective three-field lymphadenectomy still needs to be verified by high-quality clinical evidence.Big data-based mathematical models and radiomics have been applied to the clinical decisions on the diagnosis,treatment and prognosis of several diseases,and further research on these methods will contribute to esophageal cancer-related diagnosis and treatment.

关 键 词：食管癌 淋巴结转移 预测模型 

分 类 号：R73[医药卫生—肿瘤]