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目的:探讨淋巴结包膜外侵犯(ENE)对食管鳞癌病理分期和预后生存的影响.方法:收集郑州大学第一附属医院2010年2月至2012年2月R0切除、淋巴结阳性的162例食管鳞癌患者,HE染色检测ENE情况.采用门诊或住院复查方式进行随访,以随访至少5 a或患者死亡为终点事件.应用χ2检验对ENE和食管鳞癌患者临床病理特征之间的关系进行分析,应用log-rank检验进行单因素生存分析,应用COX比例风险回归模型确定ENE对预后的影响.结果:87例(53.7%)患者发生ENE.ENE的发生率与食管鳞癌的病理分期和肿瘤分化程度密切相关,单因素生存分析显示ENE阳性患者的生存期低于ENE阴性患者(P<0.001).多因素分析显示,ENE为食管鳞癌生存的独立影响因素(P<0.001),伴ENE阳性食管癌患者的全因死亡风险显著增加(RR=4.747,95% CI 3.092~7.290).结论:如将ENE的状态添进新的TNM分期系统,可更好指导预后判断.伴ENE的食管鳞癌患者预后差,应积极行辅助治疗,密切随访复发和转移状况.“,”Aim:To explore the impact of extranodal extension(ENE) on the pathological stage and prognosis of e-sophageal squamous cell carcinoma.Methods:Totally 162 cases of squamous cell carcinoma of the esophagus with R0 re-section and lymph node-positive were collected from the First Affiliated Hospital of Zhengzhou University from February 2010 to February 2012. The extranodal extension situation of lymph nodes in esophageal squamous cell carcinoma was de-tected by HE staining. Database for these patients were established by using outpatient or inpatient review for at least 5 years and relevant variables were determined. The correlation between ENE and clinicopathological features was analyzed by χ2test.Univariate survival analysis was performed using the log-rank test. Multivariate analysis was performed using the COX proportional hazards regression model to determine the effect of ENE on the prognosis. Results:There were 87 in 162 cases(53.7%) of ESCC occurred ENE. The incidence of ENE is closely related to the pathological stage and the degree of tumor differentiation of ESCC. Univariate survival analysis showed that the survival of the patients with ENE(19 months) was significantly lower than those without ENE(35 months) (P<0.001). Multivariate analysis showed that ENE was an in-dependent prognostic factor for esophageal squamous cell carcinoma(P<0.001).The risk of all-cause mortality was signifi-cantly increased in patients with ENE(RR=4.747,95% CI 3.092-7.290).Conclusion:The state of ENE is recommended to add into the new TNM staging system to better guide the prognosis. The prognosis of patients with extranodal extension is poor. So patients with ENE positive should be given assisted treatment,and follow-up of recurrence and metastasis.