中国肿瘤临床
中國腫瘤臨床
중국종류림상
CHINESE JOURNAL OF CLINICAL ONCOLOGY
2009年
23期
1325-1328
,共4页
解明然%林鹏%张旭%陈捷鑫%林勇斌%戎铁华%温浙盛%李小东%王军业%余辉
解明然%林鵬%張旭%陳捷鑫%林勇斌%戎鐵華%溫浙盛%李小東%王軍業%餘輝
해명연%림붕%장욱%진첩흠%림용빈%융철화%온절성%리소동%왕군업%여휘
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 neoplasm%Lymph node metastasis%Lymphadenectomy
目的:本研究通过分析胸中段食管鳞癌淋巴结转移规律及淋巴结转移度对预后的影响,探讨合理的淋巴结清扫范围.方法:对129例经现代二野淋巴结清扫术的胸中段食管鳞癌患者的临床资料进行回顾性分析.结果:全组患者淋巴结转移率为56.6%,总淋巴结转移度(阳性淋巴结数/清扫淋巴结总数,LMR)为11.3%,上纵隔淋巴结转移率为43.4%.最常见的淋巴结受累区域为食管旁、右喉返神经旁、贲门及胃左血管旁、隆突下.影响淋巴结转移的主要因素为肿瘤浸润深度、分化程度及肿瘤长度.无淋巴结转移组、淋巴结转移度≤20%组和淋巴结转移度>20%组患者5年生存率分别为50.4%、31.0%和6.8%,结果差异有统计学意义(P=0.000).结论:淋巴结转移度是判断食管癌预后的一个重要因素,胸中段食管癌应该常规行包括双侧上纵隔的现代二野淋巴结清扫术.
目的:本研究通過分析胸中段食管鱗癌淋巴結轉移規律及淋巴結轉移度對預後的影響,探討閤理的淋巴結清掃範圍.方法:對129例經現代二野淋巴結清掃術的胸中段食管鱗癌患者的臨床資料進行迴顧性分析.結果:全組患者淋巴結轉移率為56.6%,總淋巴結轉移度(暘性淋巴結數/清掃淋巴結總數,LMR)為11.3%,上縱隔淋巴結轉移率為43.4%.最常見的淋巴結受纍區域為食管徬、右喉返神經徬、賁門及胃左血管徬、隆突下.影響淋巴結轉移的主要因素為腫瘤浸潤深度、分化程度及腫瘤長度.無淋巴結轉移組、淋巴結轉移度≤20%組和淋巴結轉移度>20%組患者5年生存率分彆為50.4%、31.0%和6.8%,結果差異有統計學意義(P=0.000).結論:淋巴結轉移度是判斷食管癌預後的一箇重要因素,胸中段食管癌應該常規行包括雙側上縱隔的現代二野淋巴結清掃術.
목적:본연구통과분석흉중단식관린암림파결전이규률급림파결전이도대예후적영향,탐토합리적림파결청소범위.방법:대129례경현대이야림파결청소술적흉중단식관린암환자적림상자료진행회고성분석.결과:전조환자림파결전이솔위56.6%,총림파결전이도(양성림파결수/청소림파결총수,LMR)위11.3%,상종격림파결전이솔위43.4%.최상견적림파결수루구역위식관방、우후반신경방、분문급위좌혈관방、륭돌하.영향림파결전이적주요인소위종류침윤심도、분화정도급종류장도.무림파결전이조、림파결전이도≤20%조화림파결전이도>20%조환자5년생존솔분별위50.4%、31.0%화6.8%,결과차이유통계학의의(P=0.000).결론:림파결전이도시판단식관암예후적일개중요인소,흉중단식관암응해상규행포괄쌍측상종격적현대이야림파결청소술.
Objective: To explore the status of lymph node metastasis of middle third thoracic esophageal squamous cell carcinoma and its influence on the prognosis and to seek the reasonable range of lymphade-nectomy. Methods: A total of 129 patients who underwent curative esophagectomy with modern two-field lymphadenectomy of middle third thoracic esophageal squamous cell carcinoma were reviewed. Results: The lymph node metastasis rate was 56.6% and the upper mediastinal lymph node metastasis rate was 43.4%. The lymph node metastasis ratio (positive nodes/total dissected nodes, LMR) was 11.3%. Paraesophageal lymph nodes, lymph nodes near the right recurrent nerve, the left gastric and infracadnal lymph nodes were most commonly involved when the tumor was located in the middle thoracic esophagus. Tumor differentiation, the depth of tumor invasion and the length of tumor were influencing factors for lymph node metastasis. The 5-year survival of N_0, N_1 (LMR≤20%) and N_1 (LMR>20%) patients were 50.4%, 31.0% and 6.8%, respective-ly, with a significant difference among the three groups (P=0.000). Conclusion: LMR was one of the key fac-tors affecting the prognosis, of esophageal cancer. Patients with middle third thoracic esophageal carcinoma should be treated with radical surgery with modern two-field lymphadenectomy.
