食管鳞癌分化程度与淋巴结转移的关系

目的：分析食管癌高低发区食管鳞癌患者分化程度与淋巴结转移的关系。方法14335例食管鳞癌患者临床病理信息均来自河南省食管癌重点开放实验室食管癌资料库，其中高发区7007例、低发区7328例；所有患者均经手术治疗，并详细记录患者术后病理，包括分化程度和淋巴结转移等。结果高发区和低发区食管鳞癌患者均以中分化为主（48% vs 61%），低分化和高分化次之，未分化最少（0.6% vs 0.4%）。高发区男性患者40~49岁和50~59岁年龄组高分化率明显高于同年龄组低发区患者（ P 〈0.05）；但高发区女性患者仅40~49岁年龄组高分化率明显高于同年龄组低发区患者（ P〈0.05）。特别值得指出的是：高发区（ r=0.125，P〈0.05）和低发区（ r=0.105，P〈0.05）患者分化程度与淋巴结转移显著相关。结论高低发区食管鳞癌患者均以中分化为主；高发区男性和女性40~49岁年龄组高分化率均明显高于同年龄组低发区患者；分化程度与淋巴结转移关系密切，分化程度越差，淋巴结转移阳性率越高。

Differentiation and Lymph Node Metastasis in the Esophageal Squamous Cell Carcinoma

Objective To correlate the differentiation and lymph node metastasis in the patients with esophageal squamous cell carcinoma from the high- and the low-incidence areas for esophageal carcinoma. Methods All the clinical and pathological information from the 14 335 patients with esophageal squamous cell carcinoma were derived from the es@ageal carcinoma biobank in Henan Key Laboratory for Esophageal Cancer Research. Of all the pa- tients ,7 007 patients were from the high-incidence area for esophageal carcinoma and 7 328 from the low-incidence area for esophageal carcinoma. All the patients were performed surgical treatment. The detailed information, includingdifferentiation and lymph node metastasis were recorded. Results Predominantly,the middle differentiation was the common type for the patients with esophageal squamous cell carcinoma from both the high- and low-incidence areas for esophageal carcinoma （48% vs 61% ）,followed by the lower and high differentiation,the undifferentiation was very rare type for esophageal squamous cell carcinoma both in the high- and low-incidence areas for esophageal car- cinoma （0.6% vs O. 4% ）. The male patients with the age groups of 40-49 and 50-59 from the high-incidence area had the higher rate of high differentiation than those from the low-incidence area （ P 〈 0.05 ） ; furthermore, in the fe- male patients, only those with the age group of 40-49 from the high-incidence area had higher rate of high differentia- tion than those from the low-incidence area （ P 〈 0.05 ）. It was noteworthy that cancer cell differentiation was corre- lated apparently with lymph node metastasis both in the high- （ r = 0. 125, P 〈 0.05 ） and low-incidence （ r = 0. 105 ,P 〈 0.05 ） areas for esophageal carcinoma. The poor the differentiation was, the higher the rate for lymph node metastasis （ P 〈 0.05 ）. Conclusion Middle differentiation is the predominant type for the patients with esophageal squamous cell carcinoma from both the high- and low-incidence areas f