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目的探讨食管鳞癌浸润深度(T分期)与淋巴结转移的关系,为临床评判淋巴结转移情况提供重要依据。方法纳入分析的89 492例食管鳞癌手术患者,均来自郑州大学第一附属医院河南省食管癌重点开放实验室50万例食管癌和贲门癌临床信息资料库,其中男59 143例,年龄(59±8)岁;女30 349例,年龄(60±8)岁。分析食管鳞癌浸润深度(T分期)与淋巴结转移的关系。结果在纳入分析的89 492例食管鳞癌患者中,T_(is)、T_(1a)、T_(1b)、T_2、T_3、T_(4a)和T_(4b)期患者所占的比率依次为0.7%、2.9%、6.8%、30.6%、58.5%、0.4%和0.1%;35 581例发生淋巴结转移,淋巴结转移率为39.8%(35 581/89 492);103 932枚淋巴结发生转移,淋巴结转移度为11.5%(103 932/900 771)。在T_(is)~T_(4b)分期中,T4a期淋巴结转移阳性率和淋巴结转移度均最高(58.3%和22.8%),其次是T4b期(55.2%和14.8%)。随着T分期的增加(Tis~T4a),淋巴结转移率和淋巴结转移度增加(χ~2=3132.13,P<0.001;χ~2=236.12,P<0.001)、转移风险增高(R2=0.951)。不同T分期的淋巴结转移率和淋巴结转移度之间均呈显著性正相关(r=0.975,P<0.001;r=0.884,P<0.001)。结论食管鳞癌浸润深度(T分期)与淋巴结转移密切相关,提示T分期可以作为临床上间接评判淋巴结转移的重要参考指标。
Objective To investigate the relationship between the depth of invasion (T staging) and lymph node metastasis in esophageal squamous cell carcinoma and provide an important basis for clinical evaluation of lymph node metastasis. Methods 89 492 cases of esophageal squamous cell carcinoma patients included in the analysis were all from the 500,000 cases of esophageal and cardiac cancer clinical information databases of the First Affiliated Hospital of Zhengzhou University in Henan Province, and 59 of them were male and 143 patients. 59±8) years old; female 30 349 cases, age (60±8) years old. The relationship between depth of invasion (T staging) and lymph node metastasis in esophageal squamous cell carcinoma was analyzed. Results Of the 89,492 esophageal squamous cell carcinomas included in the analysis, the proportions of patients with T_(is), T_(1a), T_(1b), T_2, T_3, T_(4a), and T_(4b) were in turn 0.7%, 2.9%, 6.8%, 30.6%, 58.5%, 0.4% and 0.1%; 35 581 cases of lymph node metastasis, lymph node metastasis rate was 39.8% (35 581/89 492); 103 932 lymph node metastases, lymph nodes The degree of diversion was 11.5% (103 932/900 771). In the T_(is)~T_(4b) stage, the positive rates of lymph node metastasis and lymph node metastasis were the highest (58.3% and 22.8%), followed by T4b stage (55.2% and 14.8%). With the increase of T stage (Tis~T4a), lymph node metastasis rate and lymph node metastasis increased (χ~2=3132.13, P<0.001; χ~2=236.12, P<0.001), metastasis risk increased (R2=0.951). . There was a significant positive correlation between lymph node metastasis rate and lymph node metastasis in different T stages (r=0.975, P<0.001; r=0.884, P<0.001). Conclusion The depth of invasion (T staging) of esophageal squamous cell carcinoma is closely related to lymph node metastasis, suggesting that T staging can be used as an important reference index for indirect evaluation of lymph node metastasis.