CAJ | 학술논문

目的：分析胸段食管癌腹腔淋巴结转移规律。方法：对164例胸段食管癌手术病例的腹腔淋巴结数据进行回顾性分析。结果：胸上、中、下段三组食管癌病例，在浸润深度、分化程度、病理类型、病理分期等基础情况差异无统计学意义，三组的腹腔淋巴结转移率分别为胸上段6.9%、胸中段27.4%、胸下段39.6%，差异无统计学意义（P=0.086）。不同浸润深度、分化程度、病理类型间，腹腔淋巴结转移率差异无统计学意义。结论：食管癌存在特殊的跳跃性淋巴结转移，食管胸上段癌只要侵及黏膜下层即有可能通过毛细淋巴管网向下跳跃性转移至腹腔淋巴结，而绝大多数的食管癌诊断时已达T1b期以上，即肿瘤侵及黏膜层以下，因此并不能说早期胸上段高分化食管癌就不易发生腹腔淋巴结转移，手术时常规行腹腔淋巴结清扫是有必要的。
목적：분석흉단식관암복강림파결전이규률。방법：대164례흉단식관암수술병례적복강림파결수거진행회고성분석。결과：흉상、중、하단삼조식관암병례，재침윤심도、분화정도、병리류형、병리분기등기출정황차이무통계학의의，삼조적복강림파결전이솔분별위흉상단6.9%、흉중단27.4%、흉하단39.6%，차이무통계학의의（P=0.086）。불동침윤심도、분화정도、병리류형간，복강림파결전이솔차이무통계학의의。결론：식관암존재특수적도약성림파결전이，식관흉상단암지요침급점막하층즉유가능통과모세림파관망향하도약성전이지복강림파결，이절대다수적식관암진단시이체T1b기이상，즉종류침급점막층이하，인차병불능설조기흉상단고분화식관암취불역발생복강림파결전이，수술시상규행복강림파결청소시유필요적。
Objective:To analyze the metastasis rule of abdominal lymph node from thoracic esophagus carcinoma. Methods:The abdominal lymph node data on 164 patients who had undergone resection of thoracic esophageal carcinoma were analyzed retro-spectively. Grouping was based on the upper, middle, and lower thoracic esophagus. Differences in tumor infiltration depth, differentiat-ed degree, pathological type, pathological stage, and metastasis rate of the abdominal lymph node among the three groups were com-pared. The metastasis rates of the abdominal lymph nodes among the different tumor infiltration depths, differentiated degrees, and path-ological types were also compared. Results:The base condition of tumor infiltration depth, differentiated degree, pathological type, and pathological stage has no statistical significance among the upper, middle, and lower thoracic esophagus. The metastasis rate of the ab-dominal lymph node also has no statistical significance among the three groups (upper, 6.9%;middle, 27.4%;and lower, 39.6%). More-over, the metastasis rate of the abdominal lymph node has no statistical significance among the different tumor infiltration depths, differ-entiated degrees, and pathological types. Conclusion:A special bound lymph node metastasis was present in the esophageal carcinoma. If the tumor in the upper thoracic esophagus infiltrated the submucosa, then it could bound metastasize down to the abdominal lymph node by the lymphatic capillary net. The majority of the esophageal carcinoma was more than T1b period when diagnosed. The tumor has infiltrated the submucosa. Thus, early stage, well-differentiated, and upper thoracic esophageal carcinoma does not indicate mini-mal metastasis of the abdominal lymph node. Routine abdominal lymph node dissection through radical surgery for esophageal carcino-ma was necessary.