CAJ | 학술논문

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。本研究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%。单因素分析显示，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)，但多因素回归分析显示，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数占该段淋巴结总转移数的比率分别为57.7%、32.0%和10.0%，差异有统计学意义(P<0.05)；各段食管癌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。
배경여목적：식관암경부림파결전이솔교고，단소유전문보도。본연구분석흉단식관린암경부림파결전이특점，탐토기림상의의。방법：선택1993년1월-2003년12월재복건성종류의원행흉단식관린암삼야림파결청소근치술환자1131례，대술후병리증실경부림파결전이환자376례적구체정황진행분석。결과：전조경부림파결전이솔위33.2%，기중흉상、중급하단적경부림파결전이솔분별위43.7%、33.0%화16.0%。단인소분석현시，경부림파결전이솔여종류부위、병리분화정도、병변X선장도、pT분기이급림파결전이개수유관(P<0.05)，단다인소회귀분석현시，경부림파결전이솔지여종류부위、pT분기급림파결전이개수유관(P<0.05)。경단식관방림파결전이최다견，기차시쇄골상림파결전이，경심림파결급인후림파결전이소견；흉상、중급하단적경부림파결전이수점해단림파결총전이수적비솔분별위57.7%、32.0%화10.0%，차이유통계학의의(P<0.05)；각단식관암우경부림파결전이다우좌경부。결론：영향흉단식관린암경부림파결전이독립인소시종류부위、pT분기급림파결전이수；경단식관방림파결전이최다견，기차시쇄골상림파결전이，경심림파결급인후림파결전이소견。
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-ifeld 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 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-ifeld 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.