胸段食管癌631例淋巴结转移特点及临床意义

Metastasis and clinical significance of lymph node for 631 thoracic esophagus carcinoma patients

目的分析影响胸段食管癌淋巴结转移的因素,探讨淋巴结转移的规律和特点。方法针对631例食管癌根治术后标本进行回顾性分析,揭示主要病理改变与淋巴结转移的关系以及淋巴结转移的规律和特点。结果 631例中有淋巴结转移284例,转移率为45.0%,淋巴结转移度为15.9%(673/4 239)。食管癌胸上段、胸中段及胸下段的淋巴结转移率分别为35.6%、44.9%和50.5%。肿瘤部位越向下、长度越长、浸润深度越深淋巴结转移率越高(P<0.05),与分化程度无关。胸段食管癌淋巴结转移可见跳跃性转移和双向性转移。结论胸段食管癌淋巴结转移率与肿瘤部位、肿瘤长度和浸润深度有关,与分化程度无关。胸段食管癌淋巴结转移特点明显。

Objective To analyze the factors influencing lymph node metastasis on the thoracic esophageal carcinoma and to study the features of lymph node metastasis.Methods A retrospective study was made on the specimens of 631 patients who had underwent radical operation to explore the pattern of lymph node metastasis and the relationship of the pathological changes and lymph node metastasis.Results Lymph node metastases were found in 284 of 631 treated patients（45.0%）.In 4 239 lymph nodes dissected,metastases exsited in 673 lymph nodes（15.9%）.The rate of lymph node metastasis in the upper,middle and lower thoracic esophagus was 35.6%,44.9% and 50.5%,respectively.Lymph node metastasis related to the tumor position,tumor length and tumor invasion depth（P0.05）,but not to the differentiation of tumor cells.The characteristics of lymph node metastasis in thoracic esophageal carcinoma were upward,downward and leap spreading.Conclusion The lymph node metastasis relates with the tumor position,tumor length and tumor invasion depth,does not relate to the differentiation of tumor cells.The characteristics of lymph node metastasis in thoracic esophageal carcinoma are obvious.