肺鳞癌DNA含量定量分析及其临床意义

应用图象分析技术对４２例肺鳞癌细胞ＤＮＡ含量原位定量测定。结果显示，肺鳞癌ＤＮＡ干系处于二倍体／近二倍体（Ｄ／ＮＤ）者８例，占１９％；ＤＮＡ干系处于异倍体者（ＡＮ）３４例，占８１％。瘤体直径＞３ｃｍ、淋巴结癌转移者，其平均ＤＮＡ含量、异倍体检出率皆明显高于瘤体直径≤３ｃｍ和淋巴结阴性者。平均ＤＮＡ含量、异倍体检出率随肿瘤组织学分级的增高而升高。Ｄ／ＮＤ型肺癌５年生存率明显高于ＡＮ型肺鳞癌。结果说明，肺鳞癌ＤＮＡ含量测定有助于了解其恶性程度和发展趋势，可为临床诊断、治疗和估计预后提供依据。     

原发性肝癌DNA含量与核形态学参数关系的分析及其临床意义

本研究图像分析技术（ＩＡＴ）对５５例原发性肝癌（ＰＨＣ）病人的ＤＮＡ含量及核形态学参数进行检测，结果显示：无１例ＰＨＣ的ＤＮＡ干系水平睡于ＤＮＡ含量二倍体区域，３例处于近二倍体（５．４５％），５２例处于异倍体（９４．５５％）。ＤＮＡ含量与有无淋巴结转移（Ｐ〈０．０５）、瘤体大小（Ｐ〈０．０１）、生存率（Ｐ〈０．００１）有相关性。核形态学参数与ＰＨＣ的ＤＮＡ含量及ＰＨＣ有无淋巴结转移亦有统计学意义。     

流式细胞仪肾癌DNA含量测定

测定１０例肾癌７６个组织块肿瘤细胞ＤＮＡ含量。４例为同质性近二倍体，５例为同质性非整倍体，１例为ＤＮＡ倍体异质性，提出要明确肾癌ＤＮＡ倍体形式，应多区域取材。分析测定５８例肾癌根治术肿瘤蜡块ＤＮＡ含量。结果表明ＤＮＡ含量与病理核级、组织结构、临床分期密切相关，与细胞类型无关。随访结果表明近二倍体肿瘤预后较非整倍体肿瘤好。认为测定肾癌ＤＮＡ含量，结合病理核极、临床分期可更准确判断肾癌预后。     

胰腺肿瘤DNA含量检测及生存分析

作者对本院１９７９～１９９１年手术和病理证实的３２例胰腺癌、１０例邻近癌的胰腺组织、８例胰腺炎以及１６例胰岛细胞瘤石蜡包埋组织，用流式细胞仪（ＦＣＭ）检测其细胞核ＤＮＡ含量。结果发现：胰腺癌的异倍体率及ＤＮＡ指数明显高于胰腺非肿瘤病变者（Ｐ＜０．０１）；ＤＮＡ异倍体胰腺癌的Ｓ期比例亦明显高于二倍体胰腺癌（Ｐ＜０．０５）；胰腺癌细胞核ＤＮＡ含量的变化是一个相对独立的反映胰腺癌生物学行为的指标。ＤＮＡ二倍体胰腺癌患者的手术可切除率明显高于异倍体肿瘤患者（Ｐ＜０．０５）。采用Ｋａｐｌａｎ－Ｍｅｉｅｒ生存分析法显示，ＤＮＡ异倍体胰腺癌较二倍体者生存时间短，预后差（Ｐ＜０．０５％）。     

胃癌雌激素受体,癌胚抗原和DNA含量及其预后关系的研究

用ＡＢＣ免疫组化技术测定６５例胃癌标本中ＥＲ、ＣＥＡ含量，其中３６例标本行ＤＮＡ图像分析测定，并对影响胃癌预后的２７种因子进行Ｃｏｘ模型分析。结果发现胃癌ＥＲ、ＣＥＡ阳性率与浸润深度、淋巴结转移正相关，与分化程度负相关，ＥＲ、ＣＥＡ阴性胃癌预后较好，ＥＲ阳性胃癌对化疗较敏感。二倍体胃癌预后优于异倍体胃癌，晚期、分化差胃癌细胞核ＤＮＡ含量高。影响胃癌预后的六种因子依次为，病理类型、病程、ＤＮＡ含量、     

流式细胞术和银染核仁区在乳癌诊治中的应用

作者对４３例乳腺肿物进行ＤＮＡ流式细胞术和ＡｇＮＯＲ检测。大多数ＤＮＡ异倍体为恶性病变（２３／２４），良性病变的ＳＰＦ和ＰＩ与二倍体癌相近，但低于异倍体癌（Ｐ＞０．０５）；二倍体癌ＳＰＦ和ＰＩ低于异倍体癌（Ｐ＜０．００１）。异倍体多见于腋淋巴结转移和年轻患者（Ｐ＜０．０５）。半数左右乳腺癌的ｍＡｇＮＯＲ高于良性病变的最高值。本研究表明ＤＮＡＦＣＭ和ＡｇＮＯＲ检测可作为良恶性病变鉴别的参考，异倍体癌临床进程较快，ＤＮＡ异倍体和高Ｓ１／Ｓ２，ｍＡｇＮＯＲ肿瘤有较强的浸润性，但对化疗也较敏感，应考虑行辅助化疗。     

骨肉瘤细胞核DNA含量测定及其临床意义

应用流式细胞分析术测定５４例骨肉瘤的细胞核ＤＮＡ含量，探讨其与病理和临床特点的关系。结果表明：１０例为ＤＮＡ二倍体，４４例为异倍体。ＤＮＡ指数与骨肉瘤Ｘ线分级、肿瘤大小和外科分期有明确关系；Ｓ期细胞百分数、增殖指数与骨肉瘤外科分期也有明确相关性。预后分析表明：ＤＮＡ二倍体、低异倍体、Ｓ期细胞百分数＜２０％、增殖指数＜３５％的骨肉瘤息者有较高的三年生存率。     

胃肠道平滑肌肿瘤ras p21及DNA与预后的关系

作者应用细胞免疫荧光染色技术及流式细胞术对５５例胃肠道平滑肌肿瘤石蜡包埋标本的ｒａｓｐ２１表达及ＤＮＡ含量同时进行定量分析。结果：１４例平滑肌瘤均为二倍体和ｒａｓｐ２１低表达；１２例潜在恶性平滑肌肿瘤出现４例异倍体（３３％），９例ｒａｓｐ２１过度表达（７５％），并且大多数出现在该组的二倍体肿瘤中；２９例平滑肌肉瘤全部为异倍体（１００％）（Ｐ＜０．００５），而ｒａｓｐ２１过度表达率未见继续增高（７２％）（Ｐ＜０．００５）。３３例异倍体肿瘤的ｒａｓｐ２１过度表达率（７３％）明显高于２２例二倍体肿瘤（２７％）（Ｐ＜０．００５）。ｒａｓｐ２１低表达的二倍体肿瘤预后最好，ｒａｓｐ２１过度表达的异倍体肿瘤预后最差（Ｐ＜０．００５）。作者认为，ＤＮＡ异倍体及ｒａｓｐ２１过度表达均是恶性肿瘤的标志；ｒａｓｐ２１过度表达主要出现在恶性肿瘤的早期，并且持续稳定的表达；ｒａｓｐ２１表达和ＤＮＡ含量可以互补作为判断胃肠道平滑肌肿瘤患者预后的客观指标。     

DNA含量与嗜铬细胞瘤预后（附10例报告）

为研究ＤＮＡ倍体状况与嗜铬细胞瘤预后的关系，作者取６例肾上腺及４例肾上腺外嗜铬细胞瘤石蜡块标本，按照Ｈｅｄｌｅｙ′ｓ方法进行流式细胞计检查，测定ＤＮＡ倍体状况。回顾本组病例的临床及病理特点，并做随访。分析ＤＮＡ含量与预后的关系。结果显示：流式细胞计检查结果：异倍体７例、二倍体２例、四倍体１例。临床及病理诊断为恶性者为四倍体肿瘤。其它病例呈良性过程。作者认为，ＤＮＡ含量测定对嗜铬细胞瘤预后的判断有一定的价值。     

胆管癌DNA倍体的预后意义研究

作者应用图像分析技术对３０例胆管癌细胞核ＤＮＡ倍体进行了分析。结果显示：良性增生组织以２Ｃ细胞为主，癌变组织５Ｃ及大于５Ｃ细胞明显增多，ＤＮＡ倍体分布与病理分型、临床分期无关。Ⅲ期胆管癌二倍体组平均生存期３２个月，高倍体组为１４个月（Ｐ〈０．０５），提示ＤＮＡ倍体分析是判断胆管癌预后指标。     

STAT3及其磷酸化在食管鳞癌组织中的表达及其意义

目的 检测食管鳞癌组织中信号转导子和转录激活子3( STAT3)在mRNA、蛋白质和蛋白质磷酸化3种水平的表达,探讨其在食管鳞癌发生、发展、浸润、转移中的作用。方法 检测43例食管鳞癌组织中的STAT3 mRNA、STAT3和磷酸化STAT3( pSTAT3)的表达,并与相应癌旁正常食管组织作对照研究,分析STAT3 mRNA、STAT3和pSTAT3的表达与临床病理参数的关系。结果 43例实验样本中(1)食管鳞癌组织中STAT3 mRNA相对表达强度比值(1.43±0.59)较癌旁组织的比值(0.98±0.47)明显增高(P＜0.05);(2)食管鳞癌组织中STAT3、pSTAT3表达(2.16±0.39、1.40±0.15)也都显著高于癌旁组织(1.87±0.29、1.25±0.13,P＜0.05);(3)食管鳞癌组织中STAT3mRNA、STAT3和pSTAT3在肿瘤不同分化级别中表达差异有统计学意义,分化级别越低,表达水平越高(P＜0.05),并与肿瘤分化级别呈负相关(-1 ＜r＜-0.301,P＜0.05);它们在TNM分期中Ⅲ期组的表达均高于Ⅰ～Ⅱ期组(P＜0.05),伴有淋巴结转移组表达也都高于无淋巴结转移组(P＜0.05),并与两者呈正相关(两者均为0.301 ＜r＜1,P＜0.05);但未发现它们在性别、年龄、家族史、吸烟史中差异有统计学意义(P＞0.05)。结论 食管鳞癌组织中STAT3磷酸化异常激活后,导致STAT3mRNA、STAT3和pSTAT3的高表达,与食管鳞癌的分化、浸润、转移相关。     

VEGF-C Expression in Squamous Cell Carcinoma and Adenocarcinoma of the Esophagus

Background Vascular endothelial growth factor C (VEGF-C) is the only factor known to cause lymphangiogenesis. In esophageal cancer the histologic tumor type and lymph node metastasis are independent predictors of recurrence and poor outcome. To evaluate the rule of VEGF-C expression in esophageal cancer, we investigated 113 specimens, 59 squamous cell and 54 adenocarcinomas of the esophagus. Methods The expression of VEGF-C was evaluated using immunohistochemistry (IHC) on 59 paraffin-embedded archival specimens from patients with squamous cell esophageal carcinomas and 54 paraffin-embedded archival specimens of patients with esophageal adenocarcinomas arising in Barrett’s mucosa. All patients had a complete tumor resection. A complete and updated follow-up was available for all patients. Results The expression of VEGF-C was significantly different between the two histological types of esophageal tumors. Patients with squamous cell carcinoma and lymph node metastases had a significantly higher VEGF-C expression (P < 0.01). In patients with adenocarcinoma of the esophagus there was no correlation between VEGF-C expression and clinicopathological parameters. High VEGF-C expression tended to be correlated with poor survival in squamous cell cancer but not in adenocarcinoma of the esophagus. Conclusions The present study indicates that VEGF-C may play a role in tumor progression via lymphangiogenesis in squamous cell carcinoma of the esophagus. This seems not to be true for the adenocarcinoma of the esophagus. These data could help with the understanding of the different onset and characteristics of lymph node metastasis in squamous cell carcinoma and adenocarcinoma of the esophagus.     

食管鳞癌与细胞因子信号转导负调控因子3及其DNA甲基化的关系

目的 检测食管鳞癌(ESCC)组织中细胞因子信号转导负调控因子3(SOCS3)的DNA甲基化、mRNA及蛋白表达水平,探讨其在食管鳞癌发生、发展、浸润和转移中的作用.方法 采用甲基化特异性聚合酶链反应(MSP)、Real-Time聚合酶链反应(PCR)和Western blot法分别检测43例食管鳞癌组织中SOCS3的DNA甲基化、mRNA和蛋白表达水平,并与相应的癌旁正常食管组织进行对照研究,分析其与临床病理参数的关系.结果 (1)食管鳞癌组织SOCS3 DNA甲基化的阳性率(79.1%)明显高于癌旁组织(14.0%,P＜0.01);(2)食管鳞癌组织SOCS3 mRNA相对表达强度比值(0.53±0.30)明显低于癌旁组织(1.15±0.44,P＜0.01),食管鳞癌组织中甲基化组的SOCS3 mRNA表达(0.45±0.24)显著低于非甲基化组(0.86±0.29,P＜0.05);(3)食管鳞癌组织SOCS3蛋白表达(1.66±0.22)显著低于癌旁组织(1.83±0.15,P＜0.01),食管鳞癌组织中甲基化组SOCS3蛋白表达(1.61±0.21)显著低于非甲基化组(1.87±0.15,P＜0.01);(4)在TNM分期中Ⅲ期组表达均低于Ⅰ～Ⅱ期组(P＜0.05),伴有淋巴结转移组表达也都低于无淋巴结转移组(P＜0.05),未发现其在性别、年龄、家族史、吸烟史中有明显差异(P＞0.05);(5)食管鳞癌组织中SOCS3mRNA表达及其蛋白表达水平与肿瘤分化级别呈正相关(0.301＜r＜1,P＜0.05),与TNM分期、淋巴结转移呈负相关(-1＜r＜-0.301,P＜0.05).结论 食管鳞癌组织中SOCS3 DNA甲基化阳性率高,导致SOCS3基因表达下调,与食管鳞癌的分化、浸润和转移密切相关.     

Analysis of the malignant potentiality in superficial esophageal carcinoma by cytofluorometry of nuclear DNA and cellular protein contents--in relation to histopathologic findings and prognosis]

Recently patients with superficial esophageal carcinoma have increased due to progress in endoscopy, but the results of surgical treatment are still not satisfactory. Cytofluorometric analysis of nuclear DNA and cellular protein contents, measurements of malignant potentiality, in superficial esophageal carcinoma were performed, and DNA ploidy patterns were compared statistically with histological findings and prognosis. Nuclear DNA and cellular protein contents were measured by the multiparametric cytofluorometry in 72 patients with squamous cell carcinoma (mucosal ca.: 14 cases, submucosal ca.: 58 cases). DNA ploidy patterns were classified into diploid (without polyploid), polyploid, and aneuploid according to the peaks of the DNA content histogram. In the current study, there were 22 cases (30%) of diploid, 17 cases (24%) of polyploid, and 33 cases (46%) of aneuploid. In patients with polyploid and aneuploid, there was high frequency of lymph vessel invasion, as compared with diploid (p less than 0.01). The overall five-year survival rates of patients with diploid, polyploid, aneuploid were 91%, 71%, 55%. The prognosis in patients with aneuploid was poorer than diploid (p less than 0.05). The recurrent cases of early esophageal carcinoma were aneuploid only. DNA ploidy patterns proved to be one of the major prognostic factors by multivariate analysis. The patients with higher DNA content had a high frequency of lymph node metastasis. In the patients with poor prognosis, cellular protein content showed higher. These results suggest that the analysis of nuclear DNA and cellular protein contents are useful for assessing the prognosis and planning postoperative combined therapy in patients with superficial esophageal carcinoma.     

T2胸中段食管鳞癌淋巴结转移特点和规律

目的 探讨T2胸中段食管鳞癌淋巴结转移特点和规律.方法 分析246例接受颈、胸、腹三野淋巴结清扫的T2胸中段食管鳞癌病人的临床病理指标与淋巴结转移的关系.结果 每例病人清扫淋巴结15～59枚,平均25枚.其中129例存在区域淋巴结转移.颈、胸和腹三区淋巴结转移率分别为28.9%、28.5%和22.0%,差异无统计学意义.Logistic回归模型显示肿瘤长度、肿瘤细胞分化程度及有无淋巴管血管浸润是影响淋巴结转移的有意义因素.结论 T2胸中段食管鳞癌淋巴结转移与肿瘤长度、肿瘤细胞分化程度及有无淋巴管血管浸润明显相关;T2胸中段食管鳞癌有上、下双向转移和跳跃性转移的特点,应行三野淋巴结清扫,对胸中段超出T2的食管鳞癌也应行以上手术.

Abstract：

Objective To investigate the pattern of lymph node metastasis in patients with 17 and middle thoracic esophageal squamous cell carcinoma( ESCC). Methods Retrospective review the clinical data of 246 cases with T2 and middle thoracic esophageal squamous cell carcinoma who were treated by three-field lymphadenectomy. Analyze the relationship between clinical pathological factors and lymph node metastasis. Results Lymph node metastases were found in 129 of the 246 patients (52.4% ).The average number of resected lymph nodes was 25 per patient (rangel5 -59). The rates of lymph node metastasis were 28.9% in the neck, 28.5% in thoracic mediastinum and 22.0% in abdominal cavity for patients with T2 and middle thoracic ESCC. No significant difference in lymph node metastasis' rate was observed among the neck, thoracic mediastinum and abdominal cavity. Logistic-regression showed the length of tumor, tumor cell differentiation and angiolymphatic invasion were factors influencing lymph node metastasis. Conclusion Lymph node metastasis in T2 and middle thoracic ESCC has the characteristics of upward, downward and skip spreading. Patients with T2 and middle thoracic ESCC should be treated with radical surgery with three-field lymphadenectomy.     

细胞周期素D1（cyclin D1）和Ki67蛋白在食管鳞癌组织中的表达及临床意义

目的探讨细胞周期素D1（cyclinD1）、Ki67蛋白在食管鳞状细胞癌（esophageal squamous cell carcinoma,ESCC）中的表达及其临床意义。方法应用免疫组化方法检测28例ESCC组织和33例食管炎组织中cyclin D1蛋白、Ki67蛋白的表达。结果在ESCC与食管炎组织中cyclin D1阳性表达率分别为60.7%（17/28）和33.3%（11/33）（χ2=4.573,P=0.032）,Ki67标记指数（Ki67LI）分别为（49.21±25.15）%和（11.62±9.87）%（t=7.908,P=0.000）。ESCC组TNM分期中Ⅰ期cyclin D1阳性表达率为14.3%（1/7）,Ⅱ期为55.6%（5/9）,Ⅲ期为85.7%（6/7）,Ⅳ期为100%（5/5）,Ⅲ期与Ⅰ期、Ⅳ期与Ⅰ期相比,差异有显著性（P值分别为0.029,0.015）。有淋巴结转移者cyclin D1阳性表达率为90.9%（10/11）,无淋巴结转移者为41.2%（7/17）（P=0.016）。28例ESCC随访6～34个月,（25.0±4.2）月,死亡4例（3例为原发病进展,1例脑血管意外）,生存19例,失访5例。结论cyclin D1的表达与进展期肿瘤、淋巴结转移有关。Ki67在肿瘤中高表达,表达强弱与肿瘤分化程度及肿瘤分期无关。     

Expression of heat shock protein 70 in grossly resected esophageal squamous cell carcinoma

BACKGROUND: The aim of the present study was to use immunohistochemical methods to clarify the clinical implication of heat shock protein (HSP) 70 expression in esophageal squamous cell carcinoma and to investigate the function of HSP70 as a chaperone for p53. METHODS: Seventy-one patients with esophageal squamous cell carcinoma were admitted in the present study. Expression of HSP70 was analyzed by immunohistochemistry and correlated with TNM classification, vessel invasion, p53 expression, and clinical outcome after operation. RESULTS: Overexpression of HSP70 was related to sex (p < 0.05), tumor configuration (p < 0.05), lymph node metastasis (p < 0.01), and lymphatic vessel invasion (p < 0.05). Expression of p53 and HSP70 were not correlated with each other (p = 0.824). Esophageal squamous cell carcinoma with HSP70 expression exhibited a significantly better prognosis compared with HSP70-negative esophageal squamous cell carcinoma in univariate analysis (p < 0.05), but no significance was found in multivariate analysis. CONCLUSIONS: We suggest that HSP70 expression might be of use to assess the progression, lymph node metastasis, and lymphatic vessel invasion of esophageal squamous cell carcinoma. Inasmuch as both lymph node metastasis and HSP70 expression are prognostic variables in esophageal squamous cell carcinoma, examination of HSP70 expression may be of use to assess clinical outcome after operation.     

建立预测阴茎鳞状细胞癌区域淋巴结转移风险的列线图

目的 根据阴茎癌原发灶的病理指标,建立预测阴茎鳞状细胞癌区域淋巴结转移风险的列线图. 方法 收集1990-2005年73例阴茎鳞状细胞癌患者资料,患者均接受阴茎肿瘤切除和区域淋巴结清扫术.免疫组化法检测分子指标(p53、Ki-67、E-cadherin和MMP-9)的表达水平.采用Logistic回归模型建立列线图.预测淋巴结转移的变量包括年龄、分期、分级、蛋白表达水平(p53、Ki-67、E-cadherin和MMP-9)和脉管侵犯.其中年龄为连续变量,分期、分级、蛋白表达水平和脉管侵犯为分类变量. 结果 肿瘤分级、p53表达水平和脉管侵犯是预测区域淋巴结转移的独立预后因素(P<0.05),回归系数分别为3.97、2.12和2.37,OR值分别为52.99、8.33和10.70.用于预测淋巴结转移风险的列线图显示出良好的一致系数(0.92)和良好的校准. 结论 基于阴茎鳞状细胞癌原发灶的病理特征,构建预测区域淋巴结转移风险的列线图,不仅有助于个体化的判断肿瘤转移的风险,并且有助于与患者的交流和治疗选择.     

Abdominal Lymph Node Metastasis in Patients with Mid Thoracic Esophageal Squamous Cell Carcinoma

Background  There are few reports about abdominal lymph node metastasis of mid thoracic esophageal carcinoma. This study was designed to explore the pattern of abdominal lymph node metastasis in patients with mid thoracic esophageal squamous cell carcinoma and to evaluate the prognostic factors. Methods  The complete data of 368 patients with mid thoracic esophageal squamous cell carcinoma, who underwent modified Ivor-Lewis esophagectomy with two-field lymphadenectomy from January 1998 to January 2003, were reviewed. Survival rate was calculated by Kaplan-Meier method. Cox regression analysis was performed to identify risk prognostic factors. Results  Abdominal lymph node metastasis occurred in 58 (15.8%) patients: 34.5% (20/58) of them were stage T1 and T2. Skipping abdominal node metastasis was recognized in 13.8% (8/58) patients: all were stage T1 and T2. The overall 5-year survival rate of patients with abdominal lymph node metastasis (10.3%) was lower than that of those with thoracic node metastasis (18.3%). The prognosis of patients with distant abdominal lymph node metastasis was poor, and no one could survive more than 5 years. Cox regression analysis showed that five or more positive nodes and distant abdominal node metastasis were independent risk factors of patients with abdominal lymph node metastasis. Conclusions  Abdominal lymph node metastasis in patients with mid thoracic esophageal squamous cell carcinoma occurred frequently, and the surgery favorable for extensive abdominal lymph node dissection should be selected. The prognosis of patients with abdominal lymph node metastasis was poor, especially those with more positive nodes and distant abdominal node metastasis.     

Paratracheal lymph node metastasis is associated with cervical lymph node metastasis in patients with thoracic esophageal squamous cell carcinoma

BACKGROUND: We determined which lymph node metastases were associated with cervical lymph node metastases of thoracic esophageal squamous cell carcinoma. METHODS: A total of 6464 lymph nodes derived from 155 consecutive patients with thoracic esophageal squamous cell carcinoma were stained by immunohistochemistry (antibody: AE1/AE3). Lymph node metastases were mapped according to the mapping scheme of the American Thoracic Society, as modified by Casson et al. (Ann Thorac Surg 1994;58:1569-70). Patients were divided into two groups: those with and without cervical lymph node metastasis (CLNM). Mapping data were examined by uni- and multivariate analysis. RESULTS: Hematoxylin and eosin-positive and AE1/AE3-positive lymph node metastases were found in 59% and 77% of patients, respectively. Twenty-one (55%) of 38 patients in the CLNM(+) group and 30 (26%) of 117 patients in the CLNM(-) group had AE1/AE3-positive lymph node metastasis in the thoracic paratracheal lymph node. Paratracheal lymph node metastasis is only one independent factor for (CLNM), whereas upper thoracic paraesophageal lymph node and pulmonal hilar lymph node status were also significant in univariate analysis. Three (43%) of seven patients with cervical jumping metastasis from the thoracic esophagus had micrometastasis in the paratracheal lymph node. CONCLUSIONS: The paratracheal lymph node is most associated with (CLNM) of thoracic esophageal squamous cell carcinoma.