Siewert Ⅲ型食管胃结合部癌淋巴结转移相关因素分析

Factors related to lymph node metastasis in Siewert type Ⅲ carcinoma of esophagogastric junction

目的探讨SiewertⅢ型食管胃结合部癌淋巴结转移的影响因素。方法回顾性研究2010年1月至2018年6月扬州大学附属医院行根治性手术治疗的162例SiewertⅢ型食管胃结合部癌患者的临床及病理资料,运用Logistic回归分析影响淋巴结转移的独立影响因素。结果 162例SiewertⅢ型食管胃结合部癌患者中,72例发生淋巴结转移,转移率为44.4%。多因素回归分析显示:肿瘤病理类型、组织学分化程度、浸润深度以及有无脉管癌栓是影响胸段食管鳞癌淋巴结转移的独立危险因素(P<0.05)。结论 SiewertⅢ型食管胃结合部癌病理类型印戒细胞癌、组织学中低度分化、肿瘤侵犯胃壁全层以及脉管癌栓时,更容易发生淋巴结转移。

Objective To investigate the influencing factors for lymph node metastasis in Siewert type Ⅲ carcinoma of esophagogastric junction. Methods A total of 162 patients with Siewert type Ⅲ carcinoma of esophagogastric junction undergoing radical surgery in our department of general surgery from January 2010 to June 2018 were recruited in this study. Their clinical and pathological data were collected and retrospectively analyzed for independent influencing factors for lymph node metastasis. Results Among the 162 patients with Siewert type Ⅲ carcinoma of esophagogastric junction, lymph node metastases were found in 72 cases, with a metastatic rate of 44.4%. Multivariate logistic regression analysis showed that the pathological types of tumor, histological differentiation grade, depth of invasion and presence or absence of vascular tumor thrombus were independent risk factors for lymph node metastasis(P<0.05). Conclusion The Siewert type Ⅲ carcinoma of esophagogastric junction is more prone to lymph node metastasis in signet ring cell carcinoma, low-grade differentiation, invasion to full-thickness gastric wall and vascular tumor thrombus.