食管鳞癌淋巴结转移病理及影像学危险因素分析

目的研究食管鳞状细胞癌淋巴结转移临床病理及CT影像学危险因素，为评估有无淋巴结转移提供依据。方法回顾性分析2010年1月至2016年4月行术前CT平扫及增强检查的176例食管癌患者临床病理及影像资料，分析淋巴结转移的危险因素。结果176例患者，90例（51．14％）发生淋巴结转移。肿瘤T分期及肿瘤上下径是影响淋巴结转移的独立危险因素（P〈0．05）。以“T分期≥3”为评估标准时，敏感度及特异度分别为71．9％、52.3％，以“肿瘤长径≥4．95cm”为评估标准时，敏感度及特异度分别为48.3％、77．9％。结论术前食管鳞癌除行常规CT轴位扫描测量轴位长径外，还应补充多平面重建，测量肿瘤上下径值，从而对易发生淋巴结转移患者进行有效评估。

Objective To explore pathologic and radiological risk factors of lymph node metastasis （ LNM ） in esophageal squamous cell carcinoma （ ESCC ） and provide evidence for lymph node dissection. Methods The risk factors of LNM were analyzed retrospectively in 176 patients with ESCC who underwent preoperative Computed Tomography （ CT ） from January 2010 to April 2016. Results LNM occurred in 90 of 176 patients （ 51.14% ） . T staging and the tumor （ head-foot ） length were independent factors of LNM （ P〈0.05 ） . The sensitivity and specificity preoperatively were 71.9% and 52.3% with ＂T stagings ≥3＂ , 48.3% and 77.9% with ＂tumor （head-foot） length ≥4.95cm＂ . Conclusion Patients with ESCC who undergo CT preoperatively should be measured including not only tumor axial length but also tumor （ head-foot ） length by multi-planner reformation to predict the occurrence of LNM precisely.