论文部分内容阅读
目的:探讨胸段食管癌的淋巴结转移规律及其放疗靶区外淋巴结转移的概率。方法:对首程行颈、胸、腹三野淋巴结清除根治术的胸段食管鳞癌患者652例,进行临床病理资料分析。分析各段食管癌放疗靶区外淋巴结转移的概率。结果:胸上、中、下段食管癌淋巴结转移率颈部分别为43.2%(35/81)、27.2%(129/474)和7.2%(7/97),上纵隔分别为30.9%(25/81)、23.4%(111/474)和9.3%(9/97),中纵隔分别为13.6%(11/81)、29.1%(138/474)和30.9%(30/97),下纵隔分别为1.2%(1/81)、3.8%(18/474)和17.5%(17/97);腹部分别为11.1%(9/81)、24.5%(116/474)和52.6%(51/97)。胸上、中、下段食管癌总放疗靶区外淋巴结转移率分别为27.2%(22/81)、40.7%(193/474)和40.2%(39/97)。食管癌放疗靶区外淋巴结转移率与病变长度(χ2=7.093,P=0.029)、T分期(χ2=17.330,P=0.001)呈正相关;与肿瘤分化程度呈负相关,χ2=14.969,P=0.001;与病变部位无相关性,χ2=5.421,P=0.066。结论:胸段食管鳞癌淋巴结转移具有上下双向转移和跳跃性转移特点。以病变上下两端各扩大5cm为放疗靶区,靶区外有较高的淋巴结转移率,值得今后设计食管癌放疗靶区的注意。
Objective: To investigate the rule of lymph node metastasis of thoracic esophageal cancer and its probability of metastasis to lymph nodes outside the target area. Methods: A total of 652 patients with thoracic esophageal squamous cell carcinoma undergoing radical nephrectomy with neck, thorax and abdomen three-node lymphadenectomy were included in this study. The clinical and pathological data were analyzed. Analysis of the probability of esophageal cancer radiotherapy target lymph node metastasis. Results: The rates of lymph node metastasis in the upper, middle and lower esophageal cancer were 43.2% (35/81), 27.2% (129/474) and 7.2% (7/97), respectively, and those in the mediastinum were 30.9% (25 / (11/81), 29.1% (138/474), and 30.9% (30/97) respectively in the mediastinum, 23.4% (111/474) and 9.3% (9/97) Were 11.1% (9/81), 24.5% (116/474) and 52.6% (51/97) in the abdomen respectively, which were 1.2% (1/81), 3.8% (18/474) and 17.5% (17/97) ). The rates of total lymph node metastasis of the upper, middle and lower esophageal cancer patients were 27.2% (22/81), 40.7% (193/474) and 40.2% (39/97), respectively. The lymph node metastasis rate of esophageal carcinoma was positively correlated with the length of lesion (χ2 = 7.093, P = 0.029) and T stage (χ2 = 17.330, P = 0.001) 0.001; no correlation with lesion site, χ2 = 5.421, P = 0.066. Conclusion: The lymph node metastasis of thoracic esophageal squamous cell carcinoma has the features of up and down bidirectional metastasis and leaping metastasis. The upper and lower ends of the lesion to expand 5cm for the radiotherapy target area, the target area has a higher lymph node metastasis rate, worth the future design of esophageal cancer radiotherapy target area’s attention.