建立并验证评分系统预测食管鳞癌(cT1-3N0M0)喉返神经淋巴结转移.pdf

福建医科大学硕士学位论文 Development and Validation of Scoring System for Predicting Recurrent Laryngeal Nerve Lymph Node Metastases in Clinical Stage T1-3N0M0 Esophageal Squamous Cell Carcinoma Abstract Objectives: Recurrent laryngeal nerve lymph node (RLN LN) dissection is difficult for esophageal squamous cell carcinoma (ESCC) and usually causes recurrent laryngeal nerve injury. This study aims to develop a simple scoring system to predict RLN LN metastases in clinical stage T1-3N0M0 ESCC and explore indications for selective RLN LN dissection. Methods: Patients with clinical stage T1-3N0M0 ESCC at the Fujian Medical University Union Hospital from January 2010 to December 2014 were analyzed. Patients were divided into modeling group and validation group. Patient and pathologic characteristics were compared between patients in modeling group with RLN LN metastases and those without. Univariate and multivariate analyses were performed to establish a scoring system that estimates risk for RLN LN metastases. The scoring system is developing by weighing beta coefficient of the final model. The final model performance is evaluated by the area under the ROC curve of model group and validation group. Patients were divided into low-risk, moderate-risk and high-risk groups according to the scoring system and the indications for RLN LN dissection in various groups were validated by RLN LN metastases rate, survival rate, QOL and complications. Results: A total of 218 cases selected from 974 ESCC patients were included for analysis and randomly divided into 9 groups including 169 patients (7 groups) in modelling group and 49 patients (2 groups) in validation group. Th