胸段食管癌喉返神经旁淋巴结转移对颈淋巴结转移的预测价值

目的 探讨胸段食管癌喉返神经旁淋巴结转移对颈淋巴结转移的预测价值.方法 回顾性分析2000年1月～2013年8月因胸段食管癌接受三野根治术的64例患者临床病理资料及随访结果.结果 食管癌位于胸上段时,无论喉返神经旁淋巴结有无转移,颈部淋巴结转移率均类似（P＞0.05）.食管癌位于胸中段、胸下段时,当喉返神经旁淋巴结有转移时,颈部淋巴结转移率较高,当喉返神经旁淋巴结无转移时,则颈部淋巴结转移率较低,差异有统计学意义（P＜0.05）.喉返神经旁淋巴结、纵隔淋巴结和腹部淋巴结转移数＞4个是颈部淋巴结转移的独立预测因素.长期随访结果表明喉返神经旁淋巴结无转移的患者其5年生存率为51％,喉返神经旁淋巴结有转移的患者其5年生存率为32％,差异有统计学意义（P＜0.05）.结论 喉返神经旁淋巴结对颈部淋巴结转移有预测价值.

Thoracic Recurrent Laryngeal Lymph Node Metastases Predict Cervical Node Metastases in Selected Patients with Thoracic Esophageal Squamous Cell Carcinoma

Objective To investigate whether recurrent laryngeal nerve lymph nodes （RLN LNs） are considered sentinel nodes for cervical LN metastases of esophageal cancer.Methods We retrospectively analyzed medical records of 64 patients with thoracic esophageal cancer who underwent three-field lymphadenectomy from January 2000 to August 2013,focusing on lymph node status and survival rates.Results The rate of cervical LN metastases did not differ significantly between RLN LN ＋ （for metastasis） and RLN LN-in patients with upper thoracic esophageal tumors.However,in a subgroup of patients with middle/lower thoracic esophageal tumors,cervical LN metastases were significantly more common in patients with positive rather than negative RLN LNs.RLN metastasis and the number of lymph nodes metastasis ＞ 4 could strongly indicate the cervical LN positivity.Negative RLN LNs was associated with longer survival than RLN LN positive patients.Conclusion Metastasis to RLN LNs is a reliable indicator of cervical LN metastasis in middle/lower thoracic esophageal cancer.