淋巴结转移度对食管癌患者预后的影响

目的：探讨食管癌患者标准淋巴结清扫术后淋巴结转移度对预后的影响。方法:回顾性分析食管癌患者临床病理因素和随访资料，通过Kaplan-Meier曲线和Cox多因素回归模型分析来评估这些因素与生存期的关系。结果:245例手术患者共切除淋巴结1 758个，病理学报告112例患者共有220个淋巴结发生转移，总体转移率为45.71%，淋巴结转移度为0.13。单因素分析结果显示肿瘤残留状态、淋巴结状态和淋巴结转移度对患者5年生存率差异存在统计学意义(P<0.05）。在排除混杂因素的影响后，Cox多因素回归分析显示组织学类型、肿瘤残留状态、浸润深度、淋巴结状态和淋巴结转移度均可作为影响患者预后的独立危险因素(P<0.05）。结论:食管癌手术采用标准的淋巴结清扫术，淋巴结转移的个数不能明确影响pN1患者的预后，而淋巴结转移度对患者的预后有较强的敏感度，具有一定的参考价值。

Impact of Lymph Node Ratio on Prognosis of Patients with Esophageal Cancer

Objective：To assess the impact of lymph node ratio (LNR) on prognosis for esophageal cancer (EC) patients undergoing standard lymphadenectomy.Methods： Data including demographic, clinicopathological factors and prognostic outcome of EC patients were collected retrospectively.Kaplan-Meier curves and Cox regression analysis were used to evaluate the association between survival and these factors.Results：Of 1758 LNs yielded from 245 cases, 220 LNs were identified positive from 112 pN1 patients by pathological examination.So LN metastasis rate was 45.71% and LNR was 0.13 to the total cohort.There was a statistically significant benefit in the 5-year survival rate for patients with more radical esophagectomy, nodal negative or lower of LNR characteristics (P<0.05).After adjusting for potential confounders, multivariate Cox regression analysis revealed histological type, residual tumor status, depth of invasion, LN status and LNR could predict as independent prognostic factors (P<0.05).Conclusion：Number of involved lymph node can not predict survival based on our data, while LNR was more sensitive reflecting prognosis in standard lymphadenectomy during esophagectomy.