【作者】 傅剑华； 黄伟钊； 黄植藩； 杨名添； 林鹏； 龙浩； 曾灿光； 王欣； 王思愚； 戎铁华；

【Author】 Fu Jian-Hua Huang Wei-Zhao Huang Zhi-Fan et al. Department of Thoracic Surgery, Cancer Center,Sun Yat- SenUniversity, State Key Laboratory of Oncology in Southern China, Guangzhou 510060

【机构】 中山大学肿瘤防治中心胸科华南国家肿瘤重点实验室；

【摘要】 目的:探讨不同N1状态对胸段食管鳞癌预后的影响。方法:对我院连续收治并行根治性切除的胸段食管鳞癌N1病例共341例,对淋巴结转移数、转移度、转移区域等因子进行单因素和多因素分析,研究其与预后的关系。结果:(1)全组5年生存率为23．9％;Ⅱb期和Ⅲ期病例1、3、5年生存率分别为84．7％、43．5％、33．1％及69．8％、28．4％、20．8％, P=0．01;(2)单因素分析显示:淋巴结转移数1～3个与大于3 个的1、3、5年生存率分别是77．4％、34．8％、27．8％及5．5％、 22．6％、8．5％,P=0．001;淋巴结转移度≤20％与>20%的1、 3、5年生存率分别是76．6％、39．1％、31．8％及70．4％、23．8 ％、14．2％,P=0．003;转移的区域为1、2、3个的3年生存率分别为35．9％、24．0％、25．7％,5年生存率分别为28．0％、 15．7％、0％,P=0．009;其中,N1患者中喉返神经旁淋巴结阴性与阳性的1、3、5年生存率分别是74．8％、33．0％、25．2％及 59．2％、24．78％、0,P=0．032。(3)Cox模型多因素分析。结果:仅淋巴结转移的个数对预后有显著影响,P=0．001。结论: 根治性切除的胸段食管鳞癌N1病例的淋巴结转移数、转移度、转移的区域多少与其预后有关,但仅淋巴结转移个数是其独立预后因素,转移个数大于3个者预后较差。更多还原

【Abstract】 Objective: To explore the impact of different N1 status on prognosis in patients with esophageal squamous cell carcinoma(ESCC). Methods: The cohort of sequential 341 patients with N1 ESCC of the thoracic esophagus who underwent radical resection in our hospital was conducted. The factors including the number, percentage,area and location of nodal metastasis were chosen. Univariate and multivariate survival analysis of these factors were performed. Results: (1) The 5 years overall survival rate was 23.9%. the 1,3,5 years survival rate of stage II b and III were 84.7%,43.5%,33.1% and 69.8%,28.4%,20.8%,respectively. P=0.01 (2) Univariate analysis: The 1,3,5 years survival rate of subgroups meta-static nodal number 1-3 and >3 were 77.4%,34.8%,27.8 % and 59.5%,22.6%,8.5%, respectively. P=0.001, The 1, 3,5 years survival rate of subgroups nodal metastasis percentage ≤ 20% and >20% were 76.6%,39.1%,31.8% and 70.4%,23.8%,14.2%,respectively. P=0.003, Patients with 1,2,3 metastatic areas had a 3 year survival rate respectively were 35.9%, 24.0%, 25.7%,and 5 year survival rate respectively were 28.0%,15.7%,0 %, P=0.009, patients with positive and negative recurrent laryngeal nerve node had 1,3,5 years survival rate were 74.8%,33.0%,25.2% and 59.2%,24.7 %,0%,respectively. P=0.032. (3) Multivariate analysis: Analysis using the Cox proportional hazard model revealed that the number of metastatic node significantly influence the prognosis. P=0.001. Conclusion: The prognosis of patients with N1 ESCC of the thoracic esophagus who underwent radical resection is associated with the number, percentage and area number of nodal metastasis. The number of metastatic node is an independent prognosis factor and prognosis is worse when the metastatic node number> 3.更多还原