论文部分内容阅读
目的通过分析胸段食管鳞癌淋巴结转移方式、转移规律及其与相关病理因素的关系,探讨淋巴结合理廓清范围。方法对117例胸段食管鳞癌患者行食管癌手术中摘除有癌转移的淋巴结155枚,采用logistic回归分析临床病理因素与淋巴结转移的关系。结果胸段食管鳞癌患者无论肿瘤病理类型和临床状态如何,均有淋巴结转移。肿瘤分化程度和浸润深度对淋巴结转移率有明显的影响,肿瘤分化越低,浸润深度越深,淋巴结转移率越高。纵隔淋巴结转移多位于隆突下和癌旁,腹腔淋巴结转移多发生于胃左血管旁及胃小弯处。结论对胸段食管鳞癌应行常规胸、腹两野淋巴结清扫,尤其对T3和T4的患者,对有颈部淋巴结转移的患者应行颈、胸、腹三野淋巴结清扫;手术中对颈部可疑淋巴结转移的患者可行活组织冰冻病理检查。尽可能达到根治,提高手术疗效。
Objective To investigate the relationship between lymph node metastasis and metastasis of thoracic esophageal squamous cell carcinoma and its relationship with related pathological factors. Methods One hundred and seventeen patients with esophageal squamous cell carcinoma of the thoracic esophagus were enrolled in this study. 155 lymph node metastases were obtained from esophageal cancer surgery. The relationship between clinicopathological parameters and lymph node metastasis was analyzed by logistic regression. Results Thoracic esophageal squamous cell carcinoma patients had lymph node metastasis regardless of tumor pathological type and clinical status. The degree of tumor differentiation and depth of invasion have a significant effect on the lymph node metastasis rate. The lower the tumor differentiation, the deeper the depth of invasion, the higher the rate of lymph node metastasis. Mediastinal lymph node metastasis mostly in the subglottic and para-carcinoma, abdominal lymph node metastasis occurred in the left gastric paravertebral and gastric curvature. Conclusion Thoracic esophageal squamous cell carcinoma should be performed routine lymphadenectomy of both thoracic and abdomen, especially in patients with T3 and T4. The patients with cervical lymph node metastasis should have cervical, thoracic and abdominal lymph nodes dissection. In the operation, Suspected lymph node metastases in patients with biopsy frozen pathology. As much as possible to achieve radical and improve the efficacy of surgery.