食管癌淋巴结转移的危险因素分析

Risk factors of metastasis of lymph nodes in patients with esophageal carcinoma

目的探讨食管癌淋巴结转移的危险因素。方法回顾性分析2015年7月至2017年9月,新疆自治区人民医院胸外科行手术治疗食管癌的224例患者的病例资料,比较淋巴结转移组(转移组)与非淋巴结转移组(非转移组)的关系,并进行多因素Logistic回归进行分析,探讨淋巴结转移的危险因素。结果患者症状期较长、肿瘤长度、分化程度、肿瘤分期T与淋巴结转移有显著相关性(P <0. 05)。结论肿瘤低分化、肿瘤长度> 5 cm、肿瘤侵润深度T3~T4、患者症状期>6个月是淋巴结转移的危险因素,应尽可能选择经右胸入路胸腹腔镜辅助下食管癌根治术,并清扫双侧喉返神经淋巴结。

Objective To analyze the risk factors of the metastasis of lymph nodes in patients with esophageal carcinoma. Methods From 2015 July to 2017 September the clinical data of 224 patients after esophagectomy were summarized,and to compare the relationship between lymph node metastasis（metastasis group）and non lymph node metastasis group（non metastasis group）.Sex、age、nation、persistence time of symptom、degree of dysphagia、segmentation of tumor、lengh of tumer、degree of differentiation、staging of tumor were compared by Logistic Regression analysis,to analyze the risk factors of the of lymph nodes metastasis. Results poorly differentiated tumor、lengh of tumor more than 5centimeters、depth of penetration is T3 and T4、persistence time of symptom more than 6 months has a significant correlation in patients with lymph node metastasis（ P 〈0.05）. Conclusion The risk factors of metastasis of lymph nodes included poorly differentiated tumor、lengh of tumor more than 5centimeters、depth of penetration is T3 and T4、persistence time of symptom more than 6 months,as far as possible to choose the right chest approach for radical resection of esophageal carcinoma under laparoscope,and bilateral recurrent laryngeal nerve lymph node dissection.