论文部分内容阅读
目的分析胸段食管癌淋巴结转移规律,探讨合理的淋巴结清扫范围。方法对217例经“三区域”淋巴结清除根治术的食管癌患者的临床资料进行回顾性分析。结果全组淋巴结转移率62.6%,转移度11.38%,淋巴结“跳跃性转移”率为5.5%。胸上、中、下段食管癌颈部、胸部和腹腔淋巴结转移率分别达到31.7%、21.9%、9.75%,21.2%、30.5%、12.7%和12.1%、15.6%、34.5%。影响淋巴结转移的因素为肿瘤浸润深度、分化程度及有无淋巴管浸润(P<0.05)。结论胸段食管癌表现出上下“双向性”转移和跳跃性转移的特点,对胸段食管癌尤其是胸上、中段食管癌在条件具备时应施行“三区域”淋巴结清扫术,以提高患者的5年生存率。
Objective To analyze the rule of lymph node metastasis in thoracic esophageal cancer and explore the reasonable range of lymph node dissection. Methods The clinical data of 217 patients with esophageal cancer undergoing radical resection of “three regions” lymph nodes were analyzed retrospectively. Results The total lymph node metastasis rate was 62.6%, metastasis rate 11.38%, and lymph node “jump metastasis” rate was 5.5%. The rates of cervical, thoracic and abdominal lymph node metastasis of the upper, middle and lower esophageal cancer were 31.7%, 21.9%, 9.75%, 21.2%, 30.5%, 12.7% and 12.1%, 15.6% and 34.5% respectively. The factors influencing lymph node metastasis were depth of invasion, differentiation and lymphatic invasion (P <0.05). Conclusions Thoracic esophageal cancer has the characteristics of “two-way” metastasis and skip metastasis. Thoracic esophageal esophageal cancer, especially the upper and middle esophageal cancer, should be under the condition of “three regional” lymph node dissection to improve the patients 5-year survival rate.