贲门癌淋巴结转移的特点及意义

Lymph node metastasis in cardiac cancer:characteristic and significance

目的探讨贲门癌肿瘤大小、分化程度、浸润深度与淋巴结转移的关系,以期为贲门癌的诊断和治疗提供帮助。方法对65例采用手术治疗的贲门癌患者淋巴结进行分组并行病理检查,依据转移淋巴结的分布特点,分析转移规律。结果 65例共清扫淋巴结866个,转移度28.1%,转移率72.3%。胸腔淋巴结转移率为18/65(27.7%),腹腔淋巴结转移率为46/65(70.8%)。肿瘤大小、浸润深度、分化程度均与淋巴结转移率相关。结论贲门癌有向胸、腹腔两野淋巴结转移的倾向,多数贲门癌的淋巴结遵循逐站转移、按贲门淋巴在腹腔、胸腔的引流规律转移。外科治疗应根据肿瘤大小选择,以经胸路径为主,腹部切口为辅,清扫胸、腹腔两野淋巴结。

Objective To investigate the regularity of lymph node metastasis in patients with cardiac cancer. Methods The lymph nodes from 65 patients with cardiac cancer during tumor resection were examined pathologically and the relationship of metastasis to the tumors size, cell differentiation and invading grade were analyzed based on the microscopic findings. Results The total number of lymph nodes from 65 patients was 866. The overall rate of metastasis in 866 lymph nodes was 72.3% ,27.7% in thoracic cavity and 70.8% in celiac cavity. Conclusion This study showed that the lymph nodes metastasis of cardiac cancer tended towards down celiac firstly and then upwards thoracic cavity. It is related to the size, cell differentiation and invading grade of the tumor. And the surgical treatment should be based on the size of tumor, with through the left chest incision and with abdominal as a supplement. And this surgical procedure can clean both thoracic and celiac lymph nodes during cardiac cancer resection.