浙江实用医学
浙江實用醫學
절강실용의학
ZHEJIANG PRACTICAL MEDICINE
2014年
1期
16-20
,共5页
食管肿瘤%喉返神经%癌症TNM分期%淋巴结转移
食管腫瘤%喉返神經%癌癥TNM分期%淋巴結轉移
식관종류%후반신경%암증TNM분기%림파결전이
Esophageal neoplasms%Recurrent laryngeal nerve%Cancer TNM staging%Lymphatic metastasis
目的：通过喉返神经旁淋巴结清扫对新版食管癌TNM分期的影响，探讨该区淋巴结清扫价值。方法筛选浙江省肿瘤医院胸外科行食管癌根治术加术中喉返旁淋巴结清扫，且经病理组织学确诊为胸段食管鳞癌325例患者。采用自身对照方法，按照第7版TNM分期，逐一将325例患者分期，记作A组。假设未行喉返旁淋巴结清扫，剔除喉返旁淋巴结清扫的因素后重新分期，记作B组。应用SPSS 17.0统计软件，比较A组与B组TNM分期变化及分析其在不同胸段食管癌中的差异。结果剔除喉返旁淋巴结清扫因素，325例食管癌中有45例的N分期发生改变，使42例的TNM分期发生改变，变化率12.92％，主要分布在Ⅲ期患者。中、上段及多灶病变的食管癌的TNM分期变化明显，χ2＝13.50，P＜0.05，具有统计学意义。结论喉返神经旁淋巴结清扫，通过增加淋巴结的检出率，提高了食管癌新版TNM分期的准确性。胸中、上段及多灶的食管癌更需进行喉返神经旁淋巴结清扫。
目的：通過喉返神經徬淋巴結清掃對新版食管癌TNM分期的影響，探討該區淋巴結清掃價值。方法篩選浙江省腫瘤醫院胸外科行食管癌根治術加術中喉返徬淋巴結清掃，且經病理組織學確診為胸段食管鱗癌325例患者。採用自身對照方法，按照第7版TNM分期，逐一將325例患者分期，記作A組。假設未行喉返徬淋巴結清掃，剔除喉返徬淋巴結清掃的因素後重新分期，記作B組。應用SPSS 17.0統計軟件，比較A組與B組TNM分期變化及分析其在不同胸段食管癌中的差異。結果剔除喉返徬淋巴結清掃因素，325例食管癌中有45例的N分期髮生改變，使42例的TNM分期髮生改變，變化率12.92％，主要分佈在Ⅲ期患者。中、上段及多竈病變的食管癌的TNM分期變化明顯，χ2＝13.50，P＜0.05，具有統計學意義。結論喉返神經徬淋巴結清掃，通過增加淋巴結的檢齣率，提高瞭食管癌新版TNM分期的準確性。胸中、上段及多竈的食管癌更需進行喉返神經徬淋巴結清掃。
목적：통과후반신경방림파결청소대신판식관암TNM분기적영향，탐토해구림파결청소개치。방법사선절강성종류의원흉외과행식관암근치술가술중후반방림파결청소，차경병리조직학학진위흉단식관린암325례환자。채용자신대조방법，안조제7판TNM분기，축일장325례환자분기，기작A조。가설미행후반방림파결청소，척제후반방림파결청소적인소후중신분기，기작B조。응용SPSS 17.0통계연건，비교A조여B조TNM분기변화급분석기재불동흉단식관암중적차이。결과척제후반방림파결청소인소，325례식관암중유45례적N분기발생개변，사42례적TNM분기발생개변，변화솔12.92％，주요분포재Ⅲ기환자。중、상단급다조병변적식관암적TNM분기변화명현，χ2＝13.50，P＜0.05，구유통계학의의。결론후반신경방림파결청소，통과증가림파결적검출솔，제고료식관암신판TNM분기적준학성。흉중、상단급다조적식관암경수진행후반신경방림파결청소。
OBJECTIVE Through resecting the lymph node of recurrent laryngeal nerve effect on the TNM stage to explore the value of this region in thoracic segment esophageal carcinoma .METHODS Screening 325 patients who did radical resection surgery with re-secting the laryngeal recurrent lymph nodes in thoracic surgery of Zhejiang Cancer Hospital .We staged 325 patients one by one according to the seventh edition of TNM stage ,which as group A .Assuming no laryngeal recurrent lymph nodes resected ,we staged again after eliminating the factor of laryngeal recurrent lymph node resecting ,which as group B .SPSS 17.0 statistical software was used to compare group A and group B .We also analyzed the differences of TNM stage in different thoracic segment esophageal cancer .RESULTS After eliminating laryn-geal recurrent lymph node resecting factor ,N staging changed in 45 patients among 325 patients ,which cause 42 cases of TNM staging changed .The rate of change was 12.92% ,mainly distributed in stage Ⅲ patients .The TNM staging changed almost in the superior and mid-dle segment or multifocal lesions .The chi -square test was showed :χ2 =13.50 ,P=0.001<0.05 ,which have statistical significance . CONCLUSIONS Resecting laryngeal recurrent nerve lymph node can improve the accuracy of the new edition of TNM staging .The patients who with the tumor in the superior and middle segment or multifocal lesions need pay more attention to the resecting of laryngeal recurrent nerve lymph node .
