中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2011年
4期
297-300
,共4页
臧茹琨%宋轶鹏%马金波%杜元娜%王阳%胡立宽
臧茹琨%宋軼鵬%馬金波%杜元娜%王暘%鬍立寬
장여곤%송질붕%마금파%두원나%왕양%호립관
食管肿瘤%病理特征%放射疗法%临床靶体积
食管腫瘤%病理特徵%放射療法%臨床靶體積
식관종류%병리특정%방사요법%림상파체적
Esophageal neoplasms%Pathological features%Radiotherapy%Clinical target volume
目的 研究食管鳞癌镜下浸润转移特点及临床病理特征对其影响,为食管鳞癌临床靶体积(CTV)边界确定提供参考依据.方法 根据每个标本的收缩比计算食管组织体内每厘米长度对应的固定后长度并取材,观察64例标本肿瘤外纵向每厘米范围浸润转移情况.结果 浸润转移阳性率随着距肿瘤边缘距离增加而降低,近端和远端3 cm组出现浸润转移概率分别为4.8%和6.9%,4 cm组分别为3.6%和3.6%.肿瘤长度>5 cm、分化程度低、有淋巴结转移、T3期病例浸润转移发生率高(79.3%:45.7%、77.4%:45.5%、76.0%:51.2%、70.5%:40.0%,χ2=7.52、6.86、3.91、5.36,P=0.006、0.009、0.042、0.021).分化程度、肿瘤长度是影响食管鳞癌浸润转移的主要因素(χ2=0.19、4.82,P=0.020、0.017).结论 食管鳞癌精确放疗若要包括95%的浸润转移病灶CTV应在大体肿瘤体积(GTV)基础上纵向上放3 cm、下放4 cm,若要包括90%的浸润转移病灶则需在GTV基础上上、下均外放3 cm.同时要综合考虑病理特征对靶区范围的影响.
目的 研究食管鱗癌鏡下浸潤轉移特點及臨床病理特徵對其影響,為食管鱗癌臨床靶體積(CTV)邊界確定提供參攷依據.方法 根據每箇標本的收縮比計算食管組織體內每釐米長度對應的固定後長度併取材,觀察64例標本腫瘤外縱嚮每釐米範圍浸潤轉移情況.結果 浸潤轉移暘性率隨著距腫瘤邊緣距離增加而降低,近耑和遠耑3 cm組齣現浸潤轉移概率分彆為4.8%和6.9%,4 cm組分彆為3.6%和3.6%.腫瘤長度>5 cm、分化程度低、有淋巴結轉移、T3期病例浸潤轉移髮生率高(79.3%:45.7%、77.4%:45.5%、76.0%:51.2%、70.5%:40.0%,χ2=7.52、6.86、3.91、5.36,P=0.006、0.009、0.042、0.021).分化程度、腫瘤長度是影響食管鱗癌浸潤轉移的主要因素(χ2=0.19、4.82,P=0.020、0.017).結論 食管鱗癌精確放療若要包括95%的浸潤轉移病竈CTV應在大體腫瘤體積(GTV)基礎上縱嚮上放3 cm、下放4 cm,若要包括90%的浸潤轉移病竈則需在GTV基礎上上、下均外放3 cm.同時要綜閤攷慮病理特徵對靶區範圍的影響.
목적 연구식관린암경하침윤전이특점급림상병리특정대기영향,위식관린암림상파체적(CTV)변계학정제공삼고의거.방법 근거매개표본적수축비계산식관조직체내매전미장도대응적고정후장도병취재,관찰64례표본종류외종향매전미범위침윤전이정황.결과 침윤전이양성솔수착거종류변연거리증가이강저,근단화원단3 cm조출현침윤전이개솔분별위4.8%화6.9%,4 cm조분별위3.6%화3.6%.종류장도>5 cm、분화정도저、유림파결전이、T3기병례침윤전이발생솔고(79.3%:45.7%、77.4%:45.5%、76.0%:51.2%、70.5%:40.0%,χ2=7.52、6.86、3.91、5.36,P=0.006、0.009、0.042、0.021).분화정도、종류장도시영향식관린암침윤전이적주요인소(χ2=0.19、4.82,P=0.020、0.017).결론 식관린암정학방료약요포괄95%적침윤전이병조CTV응재대체종류체적(GTV)기출상종향상방3 cm、하방4 cm,약요포괄90%적침윤전이병조칙수재GTV기출상상、하균외방3 cm.동시요종합고필병리특정대파구범위적영향.
Objective To study the characteristics of microscopic spread of esophageal squamous-cell carcinoma (ESCC) and the influence of clinicopathological features on it to help define the clinical target volume (CTV) margin in radiotherapy.Methods Sixty-four surgical specimens of ESCC were observed for longitudinal microscopic spread per centimeter both proximally and distally from the tumor.The shrinkage ratio of each specimen was calculated and used for tissue incision.Results The further the distance beyond the tumor, the lower the incidence there was of microscopic spread.Positive rates of microscopic spread in group 3 cm of proximal and distal were 4.8% and 6.9%, respectively, and in group 4 cm were both 3.6%.Tumors longer than 5 cm in length,with poorer differentiation, lymph nodes metastasis and more aggressive phase had higher positive rates (79.3% vs 45.7%,77.4% vs 45.5%,76.0% vs 51.2%,70.5% vs 40.0%,χ2=7.52,6.86,3.91,5.36;P=0.006,0.009,0.042,0.021).Differentiation and tumor length were main factors contributing to microscopic spread (χ2=0.19,4.82;P=0.020,0.017).Conclusions To cover 95% of the microscopic spread,a margin of 3.0 cm proximal and 4.0 cm distal beyond gross tumor volume is needed and as to 90%, a margin of 3.0 cm both proximal and distal is needed.Moreover, the influence of pathological features should be taken into account.
