中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2012年
9期
982-985
,共4页
马良赟%廖泽飞%王耿杰%张乐%赖奕静
馬良赟%廖澤飛%王耿傑%張樂%賴奕靜
마량빈%료택비%왕경걸%장악%뢰혁정
食管肿瘤%淋巴结转移%淋巴结清扫术
食管腫瘤%淋巴結轉移%淋巴結清掃術
식관종류%림파결전이%림파결청소술
Esophageal neoplasmas%Lymph node metastasis%Lymph node dissection
目的 探讨胸段食管鳞癌颈部淋巴结转移的相关因素.方法 回顾性分析62例胸段食管鳞癌患者的临床资料,应用x2检验和Logistic回归分析找出颈部淋巴结转移的独立预测因子.结果 62例患者中36例(58.1％)患者发生淋巴结转移,其中有颈部淋巴结转移者15例(24.2％).全组共清扫淋巴结1954枚,平均每例清扫31.5枚,187枚(9.6％)淋巴结有转移.多因素分析显示:肿瘤位置、病变长度、胸段喉返神经旁淋巴结转移和胸部淋巴结转移、胸部淋巴结转移组数是颈部淋巴结转移的独立预测因子(OR值分别为1.976、1.346、3.012、2.023、2.254,95％ CI分别为1.436 ～ 2.538、1.032～1.683、1.572 ～6.825、1.463 ～4.745、1.483 ～4.952,P值分别为0.035、0.041、0.012、0.025、0.020).结论 颈部淋巴结转移的独立风险因子是施行选择性三野淋巴结清扫的根据,其有效性还需在临床试验中验证.
目的 探討胸段食管鱗癌頸部淋巴結轉移的相關因素.方法 迴顧性分析62例胸段食管鱗癌患者的臨床資料,應用x2檢驗和Logistic迴歸分析找齣頸部淋巴結轉移的獨立預測因子.結果 62例患者中36例(58.1％)患者髮生淋巴結轉移,其中有頸部淋巴結轉移者15例(24.2％).全組共清掃淋巴結1954枚,平均每例清掃31.5枚,187枚(9.6％)淋巴結有轉移.多因素分析顯示:腫瘤位置、病變長度、胸段喉返神經徬淋巴結轉移和胸部淋巴結轉移、胸部淋巴結轉移組數是頸部淋巴結轉移的獨立預測因子(OR值分彆為1.976、1.346、3.012、2.023、2.254,95％ CI分彆為1.436 ～ 2.538、1.032～1.683、1.572 ～6.825、1.463 ～4.745、1.483 ～4.952,P值分彆為0.035、0.041、0.012、0.025、0.020).結論 頸部淋巴結轉移的獨立風險因子是施行選擇性三野淋巴結清掃的根據,其有效性還需在臨床試驗中驗證.
목적 탐토흉단식관린암경부림파결전이적상관인소.방법 회고성분석62례흉단식관린암환자적림상자료,응용x2검험화Logistic회귀분석조출경부림파결전이적독립예측인자.결과 62례환자중36례(58.1％)환자발생림파결전이,기중유경부림파결전이자15례(24.2％).전조공청소림파결1954매,평균매례청소31.5매,187매(9.6％)림파결유전이.다인소분석현시:종류위치、병변장도、흉단후반신경방림파결전이화흉부림파결전이、흉부림파결전이조수시경부림파결전이적독립예측인자(OR치분별위1.976、1.346、3.012、2.023、2.254,95％ CI분별위1.436 ～ 2.538、1.032～1.683、1.572 ～6.825、1.463 ～4.745、1.483 ～4.952,P치분별위0.035、0.041、0.012、0.025、0.020).결론 경부림파결전이적독립풍험인자시시행선택성삼야림파결청소적근거,기유효성환수재림상시험중험증.
Objective To investigate the correlation factors of cervical lymphatic metastasis in thoracic esophageal squamous cell carcinoma.Methods Data of 62 patients with thoracic esophageal squamous cell carcinoma were retrospectively analyzed.Factors associated with cervical lymphatic metastasis were analyzed by using x2 test and multivariate Logistic regression analysis.Results Lymphatic metastasis was found in 36 cases (58.1％ ),of which metastasis in cervical lymph node was found in 15 cases(24.2％ ).A total of 1954 lymph nodes were excised,with an average of 31.5 per patient.Of all the lymph nodes,metastasis was found in 187 (9.6％) nodes.Logistic regression showed that tumor location,tumor length,thoracic lymphatic metastasis,the metastasis number of thoracic lymph nodes and thoracic lymphatic metastasis along recurrent laryngeal nerve were independent risk factors of cervical lymphatic metastasis [ OR:1.976 ( 1.436-2.538 ),P =0.035 ; 1.346(1.032-1.683),P =0.041;3.012( 1.572-6.825),P =0.012;2.023( 1.463-4.745),P =0.025 and2.254 ( 1.483-4.952 ),P =0.020,respectively ].Conclusion The independent risk factors of cervical lymphatic metastasis are foundation of selective 3-field lymph node dissection and their validities should be validated in further clinical trials.
