胸段食管鳞癌颈部淋巴结转移特点及其临床意义

doi:10.3969/j.issn.1007-3969.2013.11.012

中国癌症杂志 ›› 2013, Vol. 23 ›› Issue (11): 921-925.doi: 10.3969/j.issn.1007-3969.2013.11.012

胸段食管鳞癌颈部淋巴结转移特点及其临床意义

陈俊强¹,郑雄伟²,朱坤寿³,李建成¹,林宇¹,潘才住¹,潘建基¹

1.福建医科大学教学医院，福建省肿瘤医院放疗科，福建福州350014；
2.福建医科大学教学医院，福建省肿瘤医院病理科，福建福州350014；
3.福建医科大学教学医院，福建省肿瘤医院胸外科，福建福州350014

出版日期:2013-11-25 发布日期:2014-02-18
通信作者: 陈俊强　E-mail:junqiangc@163.com
基金资助:
福建省科技厅重点项目(2011Y0014)

Clinical analysis of the characteristics of cervical lymph node metastasis in thoracic esophageal squamous cell carcinoma

CHEN Jun-qiang¹,ZHENG Xiong-wei²,ZHU Kun-shou³,LI Jian-cheng¹,LIN Yu¹,PAN Cai-zhu¹,PAN Jian-ji¹

1. Department of Radiation Oncology, Fujian Provincial Tumor Hospital, Teaching Hospital of Fujian Medical University, Fuzhou Fujian 350014, China;
2. Department of Pathology, Fujian Provincial Tumor Hospital, Teaching Hospital of Fujian Medical University, Fuzhou Fujian 350014, China;
3. Department of Thoracic Surgery, Fujian Provincial Tumor Hospital, Teaching Hospital of Fujian Medical University, Fuzhou Fujian 350014, China

Published:2013-11-25 Online:2014-02-18
Contact: CHEN Jun-qiang E-mail: junqiangc@163.com

摘要/Abstract

摘要：

背景与目的：食管癌颈部淋巴结转移率较高，但少有专门报道。本研究分析胸段食管鳞癌颈部淋巴结转移特点，探讨其临床意义。方法：选择1993年1月—2003年12月在福建省肿瘤医院行胸段食管鳞癌三野淋巴结清扫根治术患者1 131例，对术后病理证实颈部淋巴结转移患者376例的具体情况进行分析。结果：全组颈部淋巴结转移率为33.2%，其中胸上、中及下段的颈部淋巴结转移率分别为43.7%、33.0%和16.0%。单因素分析显示，颈部淋巴结转移率与肿瘤部位、病理分化程度、病变X线长度、pT分期以及淋巴结转移个数有关(P<0.05)，但多因素回归分析显示，颈部淋巴结转移率只与肿瘤部位、pT分期及淋巴结转移个数有关(P<0.05)。颈段食管旁淋巴结转移最多见，其次是锁骨上淋巴结转移，颈深淋巴结及咽后淋巴结转移少见；胸上、中及下段的颈部淋巴结转移数占该段淋巴结总转移数的比率分别为57.7%、32.0%和10.0%，差异有统计学意义(P<0.05)；各段食管癌右颈部淋巴结转移多于左颈部。结论：影响胸段食管鳞癌颈部淋巴结转移独立因素是肿瘤部位、pT分期及淋巴结转移数；颈段食管旁淋巴结转移最多见，其次是锁骨上淋巴结转移，颈深淋巴结及咽后淋巴结转移少见。

关键词: 食管肿瘤, 颈部淋巴结转移, 淋巴结转移数, 淋巴结转移率

Abstract:

Background and purpose: Lymph node (LN) metastasis of esophageal cancer of neck rate higher, but there is little bulk reports. This article aimed to analyze the characteristics of cervical lymph node metastasis (CLN) in thoracic esophageal squamous cell carcinoma (TE-SCC) and the clinical role. Methods: A total number of 1 131 TE-SCC patients underwent radical esophagectomy plus three-field lymph node dissection at Fujian Provincial Tumor Hospital between Jan. 1993 to Dec. 2003, during which, 367 patients had pathological metastasis of CLN. Results: The metastatic rate of CLN was 33.2% for the entire group, 43.7%, 33.0% and 16.0% for the upper, middle and lower TE-SCC respectively. Single factor analysis showed that the metastatic rate of CLN was relevant with the tumor site, pathological differentiated degree, lesion length showed in X-ray, pT stage and the number of CLN (P<0.05). But multivariate regression analysis showed that the metastatic rate of CLN was just relevant with the tumor site, pT stage and the number of CLN (P<0.05). Metastasis of cervical paraesophageal lymph nodes was the most common, and supraclavicular lymph node metastasis was next, and metastasis of cervical profound lymph nodes and retropharyngeal lymph nodes were rare. The ratio of the number of CLN occupied the sum of the segmental CLN were 57.7%, 32.0% and 10.0% for the upper, middle and lower TE-SCC respectively (P<0.05). Right CLN of each segmental TE-SCC was more than left CLN. Conclusion: Independent factors on CLN in TE-SCC are the tumor site, pT stage and the number of CLN. Metastasis of cervical paraesophageal lymph nodes is the most common, and supraclavicular lymph node metastasis is next, and metastasis of cervical profound lymph nodes and retropharyngeal lymph nodes are rare. 　

Key words: Esophageal neoplasm, Cervical lymph node metastasis, Number of lymph node metastasis, Rate of lymph node metastasis

陈俊强,郑雄伟,朱坤寿,李建成,林宇,潘才住,潘建基. 胸段食管鳞癌颈部淋巴结转移特点及其临床意义[J]. 中国癌症杂志, 2013, 23(11): 921-925.

CHEN Jun-qiang,ZHENG Xiong-wei,ZHU Kun-shou,LI Jian-cheng,LIN Yu,PAN Cai-zhu,PAN Jian-ji. Clinical analysis of the characteristics of cervical lymph node metastasis in thoracic esophageal squamous cell carcinoma[J]. China Oncology, 2013, 23(11): 921-925.

[1]	高　文,梁　军,李小毅,等. 甲状腺乳头状癌淋巴结转移率和远处转移的关系[J]. 中国癌症杂志, 2017, 27(1): 26-30.
[2]	高　文,梁　军,赵　腾,等. 甲状腺乳头状癌淋巴结转移率与¹³¹I治疗后临床转归的关系[J]. 中国癌症杂志, 2016, 26(1): 67-72.
[3]	区晓敏,周鑫,史琪,等. 基于2013版颈部淋巴结分区指南的鼻咽癌淋巴结转移规律与预后价值研究[J]. 中国癌症杂志, 2015, 25(7): 535-543.
[4]	方强,董丹丹,杨红,任光国,韩泳涛,肖波. 多药耐药相关蛋白在食管鳞癌原发灶与淋巴结转移灶中的差异表达及意义[J]. 中国癌症杂志, 2014, 24(1): 15-20.
[5]	张凌,徐宽,嵇庆海,王卓颖,王宇,李端树,吴毅,朱永学. 喉癌中央区淋巴结转移：11年喉癌手术病例回顾性分析[J]. 中国癌症杂志, 2013, 23(9): 751-758.
[6]	张裔良,张杰,陈海泉,相加庆,张亚伟,陈苏峰,李鹤成,孙艺华,胡鸿,繆珑升,马龙飞,James Luketich. 新型多环黏膜切除器在食管内镜下手术的初步应用[J]. 中国癌症杂志, 2013, 23(7): 530-534.

胸段食管鳞癌颈部淋巴结转移特点及其临床意义

Clinical analysis of the characteristics of cervical lymph node metastasis in thoracic esophageal squamous cell carcinoma

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 6

编辑推荐

Metrics

本文评价