【摘要】 目的:探讨食管癌手术切除淋巴结数和转移数对生存期的影响。方法:通过问卷调查和(或)电话随访,收集1976年至2002年来自于食管癌高发区、单纯行手术治疗的食管鳞状细胞癌患者的淋巴结切除数量、转移数及生存状况资料,随访共1573例,随访期均超过10a,评估淋巴结切除数量和转移数量对预后的影响。结果:将1573例按淋巴结切除数1～6、7～12、≥13枚分组,3组的Kaplan-Meier生存曲线差异有统计学意义(χ2=15.379,P<0.001);将1573例按淋巴结转移数0、1～2、3～6、≥7枚分组,4组Kaplan-Meier生存曲线差异亦有统计学意义(χ2=180.182,P<0.001)。Cox回归模型分析结果显示,在校正了性别、浸润深度、分化程度等因素后,淋巴结切除数量增加仍是预后的保护性因素,淋巴结转移数量增加则会明显降低生存期(P<0.001)。结论:淋巴结转移数量增加是食管鳞状细胞癌患者预后差的主要因素,术中淋巴结切除数量增加是改善预后的主要因素。更多还原

【Abstract】 Aim: To investigate the influences of the number of surgically resected lymph nodes ( LNs-r) and the num-ber of metastatic lymph nodes( LNs-m) on survival of the postoperative patients with esophageal squamous cell carcinoma ( ESCC) . Methods: The questionnaire,home interview and/or telephone follow-up and hospital pathology verification were performed on 1 573 ESCC patients from ESCC high-incidence area and treated with surgery alone during 1976 ～ 2002. All the patients were followed up for more than 10 years. Results: Significant differences in the survival curve based on Ka-plan-Meier method were found among the patients with 1 ～ 6,7 ～ 12,and ≥13 LNs-r( χ 2 = 15. 379,P < 0. 001) and among the patients with 0,1 ～ 2,3 ～ 6,and ≥7 LNs-m( χ 2 = 180. 182,P < 0. 001) . The results of Cox regression analysis modelshowed that the patients with more LNs-r number or less LNs-m number would get longer survival time( P < 0. 001) . Con-clusion: Increase in LNs-r number was benefit,while increase in LNs-m number was risk for the prognosis of ESCC.更多还原