食管癌219例根治性切除的淋巴结的转移规律

目的研究淋巴结在食管癌转移的规律。方法根治性切除２１９例食管癌患者的癌组织及廓淋巴结１８７９枚并作区域分布的病理分析。结果２１９例根治性切除食管癌患者中６５例有淋巴结转移。其中胸上段食管癌８例中有２例颈深淋巴结转移。胸中段食管癌１８６例中５２例有淋巴结转移，其中伴有隆突淋巴结转移２６例，伴有食管旁、贲门区和胃左动脉旁、左下肺静脉及左下肺韧带淋巴结转移分别为１５、１２、２２、４、５例。胸下段食管癌２５例中有淋巴结转移者１１例，其中伴有食管旁、左下肺韧带、贲门区和胃左动脉旁淋巴结转移分别为１、２、５、８例。左肺动脉淋巴结无１例转移。结论淋巴结在食管癌转移的共性规律是：上段癌向上转移大于向下，下段癌向下转移大于向上，中段癌转移依次隆突区、胃左动脉旁、胸上食管旁、胸下食管旁和贲门区。左肺动脉淋巴结甚少转移。

LYMPH NODE METASTATIC PATTERNS OF 219 THORACIC ESOPHAGEAL CANCER RATIENTS

PURPOSE To study the metastatic patterns of lymph nodes in the patients with esophageal cancer. METHODS 1879 lymph nodes were dissected from 219 cases during radical esophagectomy, and were analysed pathologically. RESULTS There were 65 cases with lymph node metastases among the 219 patients. 2/8 cases of upper esophageal cancer had cervical lymph node metastases.52/186 cases of mid segment esophageal cancer had lymph node metastases:36 cases were in carina of trachea 15 along the esophagus,12 at cardia of stomach,22 at left gastric artery,4 at left inferior pulmonary vein and 5 at left pulmonary ligament 11/25 cases of lower segment esophageal cancer had lymph node metastases:1 case was along the esophagus,2 at left pulmonary ligament,5 at cardia of stomach and 8 at left gastric artery. CONCLUSION The upper esophageal cancer mostly metastasize to upper regions.The lower segment esophageal cancer mostly metastasize to cavitas abdominis.The mid segment esophageal cancer mostly metastasize to carina tracheae along the esophagus and artery gastric sinistra. Metastasis along the artery pulmonalis sinistra were rare.