经右胸颈胸腹三野清扫食管癌根治术的胸段食管癌患者喉返神经旁淋巴结转移的危险因素分析

Analysis of risk factors for metastases of recurrent laryngeal nerve lymph nodes in patients with thoracic esophageal cancer receivingradical dissectionof tumors and 3-field lymph nodesvia right chest

目的分析经右胸颈胸腹三野清扫食管癌根治术的胸段食管癌患者喉返神经旁淋巴结转移的危险因素。方法回顾性分析2016年1~12月安徽医科大学第一附属医院收治的166例经右胸颈胸腹三野清扫食管癌根治术的胸段食管癌患者的临床资料,将发生喉返神经旁淋巴结转移患者46例设为观察组,未发生喉返神经旁淋巴结转移患者120例设为对照组,对两组可能影响患者喉返神经旁淋巴结转移的影响因素(性别、肿瘤位置、肿瘤大小、病理类型等)进行单因素分析,对有统计学意义的因素进行多因素logistic回归分析。结果单因素分析显示,观察组与对照组患者年龄、隆突下淋巴结有无转移、肿瘤分化程度、肿瘤浸润深度(T分期)差异有统计学意义(P<0.05)。logistic多因素回归分析显示,肿瘤分化程度、肿瘤浸润深度与喉返神经旁淋巴结转移有相关关系(P<0.05)。结论肿瘤分化程度、肿瘤浸润深度(T分期)为喉返神经旁淋巴结转移的独立危险因素。

ObjectiveTo identify the risk factors for metastases of recurrent laryngeal nerve lymph nodes in thosepatients with thoracic esophageal cancer receivingradical dissectionof tumors and3-field lymph nodes(including both sides of the neck,chest and abdomen)via the right chestincision.MethodsThe clinical data of166patients with thoracic esophageal cancer,underwent subtotal esophageal excision and3-field lymph node(including both sides of the neck,chest and abdomen)dissection via the right chest in our hospitalbetween Jan2016and Dec2016,were retrospectively analyzed.According to with or without metastasis oftheir recurrent laryngeal nerve lymph nodes,all patients were divided into the study group(46cases)and the control group(120cases),and the possibleinfluencing factors for metastasis of recurrent laryngeal nerve lymph nodes,such asgender,tumor location,tumor size,pathologic types and so on,were identified by univariate analysis.Then multivariate Logistic regression analysis was conducted for those factors with statistical significance.ResultsThe univariate analysis showed that there were significant differences in the age,metastasis ofsubcarinallymph node,differentiationdegree,invasion depth(T stage)between patients of thetwo groups(all P<0.05).Multivariate Logistic regression analysis showed thatdifferentiation degree and invasion depth were associated with the metastasis of recurrent laryngeal nerve lymph nodes(P<0.05).ConclusionThe independent risk factors for metastasis of recurrent laryngeal nerve lymph nodesare differentiation degree and invasion depth of esophageal cancer.