胸段食管癌淋巴结转移率及转移方向

Lymph Node Metastasis Rate and Metastasis Direction of Esophageal Carcinoma

目的探讨胸段食管癌淋巴结转移率及转移方向与各种病理学相关因素之间的联系。方法回顾性分析了149例伴有淋巴结转移的食管癌根治性手术患者的临床和病理资料。结果共检出765枚淋巴结,发生转移者336枚,总转移率为43.9%,各组淋巴结的转移率依次为:锁骨上>纵隔>胃左动脉区>食管旁,其中肿瘤浸润深度和分化程度与淋巴结转移率之间的差异有显著性(P=0.003,P=0.049),而肿瘤部位、病变长度与转移率之间的差异无显著性。结论食管癌垂直转移率远大于横向转移,食管旁淋巴结不能作为食管癌的前哨淋巴结对待,应行颈胸腹三区广泛淋巴结清扫,以减少转移淋巴结的遗留,改善患者的预后。

Objective To probe the relation ship between lymph node metastasis rate and various kinds pathologic appearance of esophageal carcinoma. Methods For the 149 esophageal carcinoma cancer patients who were diagnosed, their clinical data were analyzed retrospectively. Results All of lymph node detected were 765, the metastatic were 336 and the metastasis rate was 43. 9%. The lymph node metastasis rate of various group were clavicle regional〉mediastinal〉arteriae gastrica sinistra regional〉esophagus side in order. The difference between the deep of tumor infiltration, the degree of cell differentiation and lymph node metastasis rate were significance. While the difference between the lesion site, lesion length and lymph node metastasis rate were not significance. Conclusion The lymph node metastasis rate of lengthways of esophageal carcinoma was greater than the transversal. The esophagus side lymph node could not be regarded as sentinel node of esophageal cancer. For decreasing residual of lymph node and improving prognosis of patients, extensive cervical part, thoracic part and abdominal part lymph node scavenge should be carried out.