胸段食管癌腹部淋巴结转移规律临床分析.pdfVIP

1108 中国肿瘤临床2014年第41卷第17期 ChinJClinOncol2014，Vo1．41，No．17WWW．cjco．cn 胸段食管癌腹部淋巴结转移规律临床分析 杨清杰 张 强 郭 明 摘要 目的：分析胸段食管癌腹腔淋巴结转移规律。方法：对 164例胸段食管癌手术病例的腹腔淋巴结数据进行回顾性分 析。结果：胸上、中、下段三组食管癌病例，在浸润深度、分化程度、病理类型、病理分期等基础情况差异无统计学意义，三组的腹 腔淋巴结转移率分别为胸上段6．9％、胸中段27．4％、胸下段39．6％，差异无统计学意义 (P=0．086)。不同浸润深度、分化程度、病 理类型间，腹腔淋巴结转移率差异无统计学意义。结论：食管癌存在特殊的跳跃性淋巴结转移，食管胸上段癌只要侵及黏膜下层 即有可能通过毛细淋巴管网向下跳跃性转移至腹腔淋巴结，而绝大多数的食管癌诊断时已达T。期以上，即肿瘤侵及黏膜层以下， 因此并不能说早期胸上段高分化食管癌就不易发生腹腔淋巴结转移，手术时常规行腹腔淋巴结清扫是有必要的。 关键词 食管癌 淋巴结转移 腹腔 doi：lO．3969~．issn．1000—8179 Clinicalstudyonabdominallymphnodemetastasisfrom thoracicesophaguscarcinom a QingjieYANG，QiangZHANG，MingGUO Correspondenceto：MingGUO；E—mail：gourn174@163．com DepartmentofCardio—ThoracicSurgery,ChenggongHospital，XiamenUniversity,Xiamen361003，China． Abstract 0bjective：Toanalyzethemetastasisruleofabdominallymphnodefromthoracicesophaguscarcinoma．Methods： Theabdominallymphnodedataon 164patientswhohadundergoneresectionofthoracicesophagealcarcinomawereanalyzedretro— spectively．Groupingwasbasedontheupper,middle，andlowerthoracicesophagus．Differencesintumorinfiltrationdepth，differentiat— eddegree，pathologicaltype，pathologicalstage，andmetastasisrateoftheabdominallymphnodeamongthethreegroupswerecom— pared．Themetastasisratesoftheabdominallymphnodesamongthedifferenttumorinfiltrationdepths，differentiateddegrees，andpath— ologicaltypeswerealsocompared．Results：Thebaseconditionoftumorinfiltrationdepth，differentiateddegree，pathologicaltype，and pathologicalstagehasnostatisticalsignificanceamongtheupper,middle，andlowerthoracicesophaugs．Themetastasisrateoftheab- dominallymphnodealsohasnostatisticalsignificanceamongthethreegroups(upper,6．9％；middle，27．4％；andlower,39．6％)．More- over,themetastasisrateoftheabdominallymphnodehasnostatisticalsignificanceamongthedifferenttumorinfilrtationdepths，differ— entiateddegrees，andpathologicaltypes．Conclusion：A specialbou