食管胃交界处肿瘤纵隔淋巴结转移发生率的Meta分析

Incidence of mediastinal lymph node metastasis in neoplasms at the esophagogastric junction:A Meta-analysis

目的探讨食管胃交界处肿瘤(EGJ)纵隔淋巴结转移发生率情况,为临床手术淋巴结清扫范围提供依据。方法按纳入和排除条件筛选文献,对EGJ肿瘤的纵隔淋巴结转移情况进行Meta分析,建立EGJ肿瘤纵隔淋巴结的转移图谱。结果检索文献608篇,筛选出10项文献,1714例患者入组,行纵隔淋巴结切除的1445例。EGJ上纵隔淋巴结转移率超过5.8%,中纵隔淋巴结转移率超过7.7%,下纵隔淋巴结转移率超过17.8%。纵隔淋巴结中转移发生率前3依次为110站(8.9%),106recR站(8.4%),109L站(6.6%)。转移发生率较低的是106tbL站(0)以及105站(2.8%)。结论EGJ患者第110站转移率最高,第106站淋巴结转移率次之。对于SiewertⅡ型患者,建议常规行第110站淋巴结清扫,选择性第106站淋巴结采样。

Objective To investigate the incidence of mediastinal lymph node metastasis in esophagogastric junction tumor(EGJ),and to provide a basis for clinical lymph node dissection.Methods The mediastinal lymph node metastasis of EGJ tumors was analyzed by Meta analysis according to the inclusion and exclusion conditions.And the metastasis map of mediastinal lymph nodes of EGJ tumors was established.Results A total of 608 articles were retrieved,with 10 articles being selected.In total,1714 patients were enrolled,and 1445 patients underwent mediastinal lymph node resection.The rates of upper mediastinal lymph node metastasis,middle mediastinal lymph node metastasis and lower mediastinal lymph node metastasis exceeded 5.8%,7.7%and 17.8%,respectively.The incidence of metastasis in mediastinal lymph nodes was 110 stations(8.9%),106recR stations(8.4%)and 109L stations(6.6%).The incidences of metastases were lower at 106tbL(0)and 105(2.8%)stations.Conclusions The metastasis rate of EGJ patients at station 110 was the highest,followed by the lymph node metastasis rate at station 106.It is recommended that patients with Siewert typeⅡundergo routine lymph node dissection at station 110 and selective lymph node sampling at station 106.