【摘要】 目的:探讨胸段食管癌淋巴结转移的相关因素和淋巴结转移数的临床意义。方法:以1146例胸段食管鳞状细胞癌单纯手术切除的临床病理资料,应用Kaplan-Meier生存曲线和Spearnam相关分析进行研究。结果:全组1146例食管癌中淋巴结转移380例(转移率33.2%);共清除淋巴结4270个,其中转移807个(转移度18.9%)。肿瘤侵及深度为Tis、T1、T2、T3和T4的淋巴结转移率分别为0、20.0%、25.7%、37.3%和50.0%(P<0.001)。肿瘤长度为<3.0、3～5.0、5.1～7.0cm和>7.0cm的淋巴结转移率分别为12.8%、29.6%、37.3%和46.8%(P<0.001)。细胞分化程度为高中分化和低分化的淋巴结转移率分别为32.4%和48.2%(P=0.014)。以上3种因素对淋巴结转移的影响均有统计学差异。性别、年龄、肿瘤部位和病理形态分型对淋巴结转移的影响没有统计学意义。淋巴结转移数为0、1和≥2的5年生存率分别为59.79%、33.38%和9.35%;三组间的的生存率差别具有显著性(P<0.01)。结论:淋巴结转移的主要影响因素是肿瘤侵及深度、肿瘤长度和肿瘤细胞分化程度,淋巴结转移数能够反映食管癌切除术患者的预后。更多还原

【Abstract】 Objective:To evaluate correlation factors of lymphatic metastasis(LM) in thoracic esophageal carcinoma and to examine the clinical significance of the number of metastatic lymph nodes(NMLN) .Methods:Research on clinicopathological data of 1,146 patients,who had undergone simple resection of squamous cell carcinoma of the thoracic esophagus,was performed using Kaplan-Meier survival curves and Spearmam correlation analysis.Results:LM was found in 380 of the 1146 cases with esophageal carcinoma(33.2%) ,and in the 4,270 excised lymph nodes,metastases can be seen in 807(18.9%) .The LM rate was 0.0%,20.0%,25.7%,37.3% and 50.0% for the depth of tumor invasion(T) of Tis,T1,T2,T3 and T4(P<0.001) and the LM rate tumors of length less than 3 cm,3 to 5 cm,5.1 to 7 cm and more than 7 cm was 12.8%,29.6%,37.3% and 46.8%,respectively(P<0.001) .The LM rate was 32.4% in the well and moderately differentiated cells and 48.2% in the poorly differentiated cells.There was a statistical difference among the effects of the above 3 factors on the LM,but no obvious statistical significance was found among sex,age,tumor site or pathomorphological typing to affect LM.The 5-year survival rate for the cases with the NMLN of 0,1 and more than or equal to 2 was 59.79%,33.38% and 9.35%,respectively.There was a significant difference among the survival of the 3 groups(P<0.01) .Conclusion:The major influential factors of LM in squamous cell carcinoma of the thoracic esophagus are the depth of tumor invasion,the tumor length and the cellular differentiation of the tumor.The NMLN can reflect the prognosis of patients undergoing surgery for squamous cell thoracic esophageal carcinoma.更多还原