胸段食管鳞癌喉返神经旁淋巴结转移的危险因素分析

Risk Factors of Recurrent Laryngeal Nerve Lymph Node Metastasis in Patients with Thoracic Esophageal Squamous Cell Carcinoma

目的探讨胸段食管鳞癌喉返神经旁淋巴结转移的危险因素。方法回顾性分析2015年1月至2019年3月在郑州大学第一附属医院胸外科接受食管癌根治术并喉返神经旁淋巴结清扫的349例胸段食管鳞癌患者的临床资料。采用单因素和多因素分析胸段食管鳞癌喉返神经旁淋巴结转移的危险因素。结果349例患者中有72例患者出现喉返神经旁淋巴结转移,转移率为19.5%。单因素分析显示,肿瘤位置、肿瘤分化程度和病理T分期是胸段食管鳞癌喉返神经旁淋巴结转移的危险因素(均P<0.05)。多因素Logistic回归分析显示,肿瘤位置、肿瘤分化程度和病理T分期是胸段食管鳞癌喉返神经旁淋巴结转移的独立危险因素(均P<0.05)。结论肿瘤位置、肿瘤分化程度和病理T分期是胸段食管鳞癌喉返神经旁淋巴结转移的独立危险因素,应常规对胸上段、分化程度差及侵犯程度深的食管鳞癌行喉返神经旁淋巴结清扫。

Objective To investigate the risk factors of recurrent laryngeal nerve lymph node metastasis in patients with thoracic esophageal squamous cell carcinoma.Methods Clinicopathological data of 349 patients with thoracic esophageal squamous cell carcinoma received esophagectomy with bilateral recurrent laryngeal nerve lymph nodes dissection in the First Affiliated Hospital of Zhengzhou University from January 2015 to March 2019 were retrospectively analyzed.The risk factors of recurrent laryngeal nerve lymph nodes metastasis were analyzed by univariable and multivariable methods.Results In the 349 patients,72 patients had recurrent laryngeal nerve lymph node metastasis,with a metastasis rate of 19.5%.Single factor analysis showed that tumor location,the degree of tumor differentiation,and pathologic T classification were the risk factors for metastasis of recurrent laryngeal nerve lymph nodes(all P<0.05).Multivariable analysis showed that tumor location,the degree of tumor differentiation,and pathologic T classification were significantly associated with metastasis of recurrent laryngeal nerve lymph nodes(all P<0.05).Conclusion Tumor location,the degree of tumor differentiation,and pathologic T classification were independent risk factors for recurrent laryngeal nerve lymph nodes metastasis.The recurrent laryngeal nerve lymph nodes should be routinely dissected for esophageal squamous cell carcinomathe of upper thoracic segment,poor pathologic differentiation and high degree of pathologic T classification.