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胸段食管鳞癌颈部淋巴结转移特点及其临床意义

发表者:陈俊强 1273人已读

陈俊强,郑雄伟,朱坤寿,李建成,林宇,潘建基

福建医科大学教学医院、福建省肿瘤医院放疗科,福建 福州350014

通信作者:陈俊强,E-mail: junqiangc@163.com

《中国癌症杂志》2013年第23卷第11期CHINA ONCOLOGY 2013 Vol.23 No.11

 

[摘要] 背景与目的:食管癌颈部淋巴结转移率较高,但少有专门报道。本文分析胸段食管鳞癌颈部淋巴结转移特点,探讨其临床意义。方法:选择1993年1月—2003年12月在福建省肿瘤医院行胸段食管鳞癌三野淋巴结清扫根治术患者1131例,对术后病理证实颈部淋巴结转移患者376例的具体情况进行分析。结果:全组颈部淋巴结转移率为33.2%,其中胸上、中及下段的颈部淋巴结转移率分别为43.7%、33.0%和16.0%。单因素分析颈部淋巴结转移率与肿瘤部位、病理分化程度、病变X线长度、pT分期以及淋巴结转移个数有关(P<0.05),但多因素回归分析颈部淋巴结转移率只与肿瘤部位、pT分期及淋巴结转移个数有关(P<0.05)。颈段食管旁淋巴结转移最多见、其次是锁骨上淋巴结转移,颈深淋巴结及咽后淋巴结转移少见;胸上、中及下段的颈部淋巴结转移个数占该段淋巴结总转移个数的比例分别为57.7%、32.0%、10.0%,差异有统计学意义(P<0.05);各段的右颈部淋巴结转移多于左颈部。结论:影响胸段食管鳞癌颈部淋巴结转移独立因素是肿瘤部位、pT分期及淋巴结转移个数;颈段食管旁淋巴结转移最多见,其次是锁骨上淋巴结转移,颈深淋巴结及咽后淋巴结转移少见。福建省肿瘤医院放疗科陈俊强

[关键词] 食管肿瘤/外科学;颈部淋巴结转移;淋巴结转移个数;淋巴结转移率

Clinical analysis of the characteristics of cervical lymph node metastasis in thoracic esophageal squamous cell carcinoma

CHEN Juan-qiang, ZHENG Xionag-wei, ZHU Kun-shou, LI Jian-cheng, LIN Yu, PAN Cai-zhu, PAN Jian-ji(Department of Radiation Oncology, Fujian Provincial Tumor Hospital, Teaching Hospital of Fujian Medical University, Fuzhou Fujian 350014, China)

Correspondence author: CHEN Jun-qiang   E-mail: junqiangc@163.com

基金项目:福建省科技厅重点项目(2011Y0014)。

通信作者:陈俊强  E-mail: junqiangc@163.com

[Abstract] Background and purpose: Lymph node (LN) metastasis of esophageal cancer of neck rate higher, but there is little bulk reports. This article aimed to analyze the characteristics of cervical lymph node metastasis (CLN) in thoracic esophageal squamous cell carcinoma (TE-SCC) and the clinical role. Methods: A total number of 1 131 TE-SCC patients underwent radical esophagectomy plus three-field lymph node dissection at Fujian Provincial Tumor Hospital between Jan. 1993 to Dec. 2003, during which, 367 patients had pathological metastasis of CLN. Results: The metastatic rate of CLN was 33.2% for the entire group, 43.7%, 33.0% and 16.0% for the upper, middle and lower TE-SCC respectively. Single factor analysis showed that the metastatic rate of CLN was relevant with the tumor site, pathological differentiated degree, lesion length showed in X-ray, pT stage and the number of CLN (P<0.05). But multivariate regression analysis showed that the metastatic rate of CLN was just relevant with the tumor site, pT stage and the number of CLN (P<0.05). Metastasis of cervical paraesophageal lymph nodes was the most common, and supraclavicular lymph node metastasis was next, and metastasis of cervical profound lymph nodes and retropharyngeal lymph nodes were rare. The ratio of the number of CLN occupied the sum of the segmental CLN were 57.7%, 32.0% and 10.0% for the upper, middle and lower TE-SCC respectively (P<0.05). Right CLN of each segmental TE-SCC was more than left CLN.Conclusion: Independent factors on CLN in TE-SCC are the tumor site, pT stage and the number of CLN. Metastasis of cervical paraesophageal lymph nodes is the most common, and supraclavicular lymph node metastasis is next, and metastasis of cervical profound lymph nodes and retropharyngeal lymph nodes are rare.

[Key words] Esophageal neoplasm/surgery; Cervical lymph node metastasis; Number of lymph node metastasis; Rate of lymph node metastasis


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发表于:2014-12-07 19:49

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