VEGFR-3与大肠癌淋巴结转移关系的研究

目的检测血管内皮生长因子受体3（VEGFR-3）在大肠癌中的表达,探讨其与淋巴结转移的关系。方法标本来自南昌大学第四附属医院普外科2006年1～6月手术根治性切除大肠癌56例,详细记录患者临床病理情况,并以同时期同科室手术切除20例结肠良性腺瘤作为对照。应用免疫组化方法检测组织标本中的VEGFR-3蛋白表达,并计算微淋巴管密度（LMVD）。结果VEGFR-3在大肠癌中的表达强度明显较大肠腺瘤中的高,差异具有显著性（P〈0．05）。大肠癌中LMVD数值高于大肠腺瘤中的LMVD,差异具有显著性（P〈0．05）。结论VEGFR-3蛋白在大肠癌组织中表达增高,并可能与大肠癌的经淋巴道转移增加有关。     

Long noncoding RNA LINC01296 plays an oncogenic role in colorectal cancer by suppressing p15 expression

ObjectiveTo examine the role of the long noncoding RNA LINC01296 in colorectal carcinoma (CRC) and to explore the underlying mechanism.MethodsWe detected LINC01296 expression levels in a cohort of 51 paired CRC and normal tissues. We also assessed the effects of LINC01296 on cell proliferation and apoptosis in CRC cells in vitro, and measured its effect on tumor growth in an in vivo mouse model. We identified the potential downstream targets of LINC01296 and assessed its regulatory effects.ResultsExpression levels of LINC01296 were elevated in 37/51 CRC tissues compared with the corresponding normal tissues and were significantly associated with tumor stage, lymph node metastasis, and distant metastasis. Knockdown of LINC01296 using antisense oligonucleotides inhibited cell proliferation and promoted apoptosis of colon cancer cells in vitro and inhibited tumor growth in vivo. Knockdown of LINC01296 also significantly increased the gene expression of p15 in colon cancer cells. LINC01296-specific suppression of p15 was validated by the interaction between enhancer of zeste homolog 2 and LINC01296.ConclusionOverexpression of LINC01296 suppressed the expression of p15 leading to CRC carcinogenesis. These findings may provide the basis for novel future CRC-targeted therapies.     

直肠癌患者淋巴结转移的相关因素分析

目的 探讨直肠癌淋巴结转移规律及其相关影响因素，为综合治疗直肠癌提供依据。方法 回顾性分析139例施行根治性手术治疗直肠癌患者的临床资料，分类分析其与淋巴结转移的关系。结果 直肠癌患者淋巴结转移与性别、病变部位无明显关系（P〉0.05）；年龄〈40岁组惠者淋巴结转移高于／〉40岁组（P〈0．05）。与分化程度、浸润深度和大体类型有关，并以分化程度对淋巴结转移的影响为首位（P〈0、01）。结论 直肠癌患者的年龄、癌肿大小、浸润深度、分化程度和大体类型等均可影响淋巴结转移，分化程度为影响淋巴结转移的首要因素。     

食管癌淋巴结转移危险因素分析

目的分析食管癌淋巴结转移的危险因素。 方法回顾性研究郑州大学第一附属医院2016年12月至2017年12月行食管癌根治术的患者150例,记录患者的病历资料、术后病理资料,分析年龄、性别、病变部位、肿瘤分化程度、肿瘤浸润深度、肿瘤长度（肿瘤长径）等可能与食管癌淋巴结转移有关的危险因素,对这些因素进行单因素χ²检验及logistic多因素分析。 结果150例食管癌患者中,淋巴结转移患者为60例,转移率为40%。单因素χ²检验显示,在不同肿瘤分化组和肿瘤长径组,淋巴结转移患者和无淋巴结转移患者例数差异有统计学意义（χ²=16.928,P<0.001;χ²=12.06,P=0.002）;淋巴结转移患者和无淋巴结转移患者在年龄、性别、病变部位、肿瘤浸润深度方面差异无统计学意义（P均>0.05）。logistic多因素分析显示,肿瘤分化程度和肿瘤长径是淋巴结转移的独立危险因素。 结论肿瘤分化程度和肿瘤长径是食管癌淋巴结转移的独立危险因素,淋巴结清扫及术后治疗应根据淋巴结转移情况进行综合评估。     

2型糖尿病与结直肠癌淋巴结转移关系的病例对照研究

目的探讨2型糖尿病和结直肠癌患者淋巴结转移的关系。方法收集重庆医科大学附属第一医院2016年1月1日至2017年7月1日符合纳入标准的1 624例结直肠癌患者进行回顾性病例对照研究,分析其中合并2型糖尿病患者(n=208)与未合并糖尿病患者(n=1 416)的淋巴结转移情况。统计学检验水准取α=0. 05,当采用R×C表χ~2检验分割法时,检验水准调整为α’=0. 017。结果淋巴结转移者638例,合并糖尿病组中96例,非糖尿病组中542例,糖尿病组结直肠癌淋巴结转移率高于非糖尿病组(46. 2%vs 38. 3%,P=0. 030)。糖尿病组208例中长期糖尿病患者(糖尿病病程> 2年) 152例,短期糖尿病患者(糖尿病病程≤2年组) 56例,长期糖尿病患者淋巴结转移率高于非糖尿病组(48. 7%vs 38. 3%,P <0. 017)。淋巴结转移率在T3~T4期糖尿病患者(n=157)为56. 1%,在T3~T4期非糖尿病患者(n=1 074)为44. 6%,在T1~T2期糖尿病患者(n=51)为15. 7%,在T1~T2期非糖尿病患者(n=342)为18. 4%;糖尿病T3~T4期淋巴结转移率高于糖尿病T1~T2期(P <0. 017)。结论合并糖尿病、尤其是糖尿病病程大于2年的结直肠癌患者淋巴结转移的风险增高。T分期较高的结直肠癌患者淋巴结转移风险较高,但尚未显示糖尿病对不同T分期患者淋巴转移率有统计学意义的影响,有待进一步研究。     

TYMS serves as a prognostic indicator to predict the lymph node metastasis in Chinese patients with colorectal cancer

Objective

The current study is to evaluate the effect of thymidylate synthase (TYMS) on lymph node metastasis (LNM) in Chinese colorectal cancer (CRC) patients, and develop potential LNM-associated biomarkers for CRC.

Design and methods

Differences in TYMS gene expression between primary CRC with LNM (LNM CRC) and without LNM (non-LNM CRC) were assessed using quantitative real-time PCR analysis in 100 Chinese colorectal cancer patients. The relationship between clinicopathological parameters and prognosis of candidate biomarkers was also examined in the experiment.

Results

TYMS was significantly upregulated in LNM CRC compared with non-LNM CRC, which was confirmed by real-time quantitative polymerase chain reaction. Overexpression of TYMS was significantly associated with LNM (P < 0.001), advanced TNM stage (P < 0.001), increased 5-year recurrence rate (P < 0.001) and decreased 5-year overall survival rate (P < 0.001). Univariate and multivariate analyses indicated that TYMS expression was an independent prognostic factor for recurrence and survival of CRC patients (P < 0.05).

Conclusions

TYMS effect on lymph node metastasis in CRC might serve as a potential biomarker for LNM and a prognostic factor in CRC. Over-expression of TYMS is a predicting factor to the poor outcome in clinical colorectal cancer patients.     

Long noncoding RNA CCDC26 as a potential predictor biomarker contributes to tumorigenesis in pancreatic cancer

Pancreatic cancer (PC) is the fourth most common cancer worldwide and has the least patient survival rate of any cancer. Emerging studies have demonstrated that long noncoding RNAs (lncRNAs) were present in cancer patients and have shown great potential as powerful markers and therapeutic targets. However, little is known about the role of lncRNAs in PC. The present study aimed to investigate the expression pattern, clinical significance and biological function of lncRNA CCDC26 (CCDC26) in PC. With quantitative real-time PCR, we analyzed CCDC26 expression levels in 40 PC patients. We found that the CCDC26 expression was significantly higher in PC tissues than in normal tissues. CCDC26 levels were correlated with tumor size, tumor number, and reduced overall survival (OS). Univariate and multivariate analysis showed that CCDC26 expression is an independent prognostic factor of OS in patients with PC. Additionally, ROC^AUC of CCDC26 was up to 0.663, implicating that CCDC26 could be a diagnostic marker for distinguishing PC from normal. Knockdown of CCDC26 expression by small interfering RNA significantly promoted growth arrest and apoptosis. Moreover, we found that the expression of CCDC26 was positively correlated with PCNA and Bcl2. Our data suggest that CCDC26 may be identified as a novel oncogene in PC, and responsible for growth and apoptosis of cancer cell, partly by regulating the PCNA and Bcl2 expression. This work provides a novel biomarker and therapeutic target of PC for cancer clinic in future.     

CT显示胃癌病灶体积、强化程度、病理指标与胃周淋巴结转移的相关性研究

目的分析CT显示胃癌病灶体积、增强前后强化差值、组织分化程度、免疫组化指标与胃周淋巴结转移的相关性,探讨CT征象及病理指标预测淋巴结转移的可能性。方法回顾性分析57例行胃癌根治术患者的术前CT图像,测量CT图像上病变体积、增强前后强化差值,术后评估病变的分化程度,p53、Ki-67、表皮生长因子受体（EGFR）表达水平及胃周淋巴结转移情况。按是否有胃周淋巴结转移将患者分为两组,比较转移组与无转移组在CT显示胃癌病灶体积、强化差值及病理指标方面的差异。应用多因素方差分析筛选以上参数中预测胃周淋巴结转移的独立因素,并对独立因素与转移淋巴结数量进行相关性分析,对计量预测因素用受试者工作特征（ROC）曲线选出最佳预测界值。结果 36例患者手术证实胃周淋巴结转移,余21例未见淋巴结转移。转移患者病灶的CT体积[（33.0±25.0）cm^3]显著大于无转移患者[（33.0±25.0）cm^3 vs.（6.4±4.4）cm^3,P〈0.05],但两者强化差值无显著差异。淋巴结转移患者病变的EGFR阳性率（24/36）明显高于无转移患者（9/21）（P〈0.05）,但两者Ki-67和p53指标差异无统计学意义。多因素方差分析进一步表明,仅有肿瘤体积及分化程度可作为预测淋巴结转移的独立因素（P〈0.05）,且肿瘤体积与转移淋巴结数量呈显著正相关,6 cm3为肿瘤体积对转移淋巴结的最佳预测界值（灵敏度100.0%,特异度87.5%）。低分化患者的淋巴结转移数也显著高于中分化患者（P〈0.05）。结论 CT上胃癌病灶体积及组织分化程度与胃周淋巴结转移具有一定相关性,可能有助于提高对淋巴结转移的预测。     

早期胃癌淋巴结转移阳性的淋巴结清扫范围对患者预后的影响

目的探讨早期胃癌淋巴结转移阳性的淋巴结清扫范围对患者预后的影响。方法选择早期胃癌患者共129例,分为淋巴结转移阴性组(102例)和阳性组(27例),淋巴结清扫的方式包括D1和D2清扫术,收集所有纳入对象的临床病理资料并进行随访。结果除TNM分期外,淋巴结转移阴性组和阳性组在性别构成比、年龄、肿瘤直径、肿瘤部位、Borrmann分型、组织类型、分化程度方面均无统计学差异(P0.05)。采用D2清扫术的早期胃癌患者生存率显著高于D1清扫术(P0.05)。在淋巴结转移阳性的患者中,采用D2清扫术的患者生存时间显著高于D1清扫术(P均0.05)。在淋巴结转移阴性的患者中,D1清扫术和D2清扫术的患者中位生存时间无统计学差异(P0.05)。结论早期胃癌在无法准确评估淋巴结转移情况时,应首选D2清扫术。     

Aspirin reduces lung cancer metastasis to regional lymph nodes

Background

Lung cancer is the main cause of cancer-related death worldwide. The high mortality is probably attributable to early metastasis; however, the mechanism underlying metastasis to regional lymph nodes is still unknown. Cyclooxygenase (COX)-derived prostaglandin E₂ (PGE₂) induces tumor growth and metastasis and is associated with a poor prognosis. The present study investigated the effect of an authentic COX inhibitor, aspirin, on regional lymph node metastasis during the development of lung cancer in mice.

Methods

An orthotopic intrapulmonary implantation model based on male C57BL/6 (6–8-weeks-old) mice was used. The lungs were injected with a solution containing Lewis lung carcinoma (LLC) cells overexpressing green fluorescent protein (GFP) and BD Matrigel^®. The effect of aspirin on mediastinal lymph node metastasis of LCC cells from the primary injection sites was then examined.

Results

The implantation process took approximately 30 s per mouse and operative mortality was 10%. Single pulmonary nodules developed at the implanted site in 95% of animals, and regional mediastinal lymph node metastasis was observed at 14 days post-LLC-GFP cell injection in all mice that formed a primary lung tumor. The mean survival time of mice injected with LLC-GFP cells was 15 ± 3 days (range, 12–22 days). Histopathological analysis revealed that no metastatic tumors developed in the regional mediastinal lymph nodes by Day 10–12 post-LLC-GFP cell injection and no metastasis to distant organs or distant lymph nodes was observed by Day 21 post-injection. Oral administration of aspirin (100 mg/kg, twice a day) after LLC-GFP cell injection inhibited metastasis to the regional lymph nodes, with no significant suppression of primary tumor growth in the lungs. Aspirin treatment led to a significant reduction in mortality (P < 0.0001).

Conclusions

The present lymph node metastasis model is useful for evaluating the efficacy of agents that inhibit tumor metastasis to the regional lymph nodes. Aspirin reduced the metastasis of LLC-GFP cells injection to the regional lymph nodes, with a significant reduction in mortality. These findings suggested that COX inhibitors have potential for preventing lymph node metastasis.     

基于术前超声的列线图模型预测卵巢癌患者淋巴结转移的临床价值

目的：卵巢癌(OC)是全球女性最常见的癌症之一,我们研究的目的是探究卵巢癌患者淋巴结转移的危险因素,以此指导临床手术和治疗。方法：纳入2014年4月-2022年5月的卵巢癌患者资料,通过Logistic回归分析,建立卵巢癌淋巴结转移的预测模型,并绘制列线图,使用ROC曲线、校准图和决策分析曲线评价模型的效能。结果：在333例训练集患者中,有92例(27.6%)患者发生淋巴结转移。肿瘤最大径, 多灶性和Ki67水平是淋巴结转移的独立危险因素。根据多因素分析结果构建列线图,训练集中ROC曲线的AUC=0.819(95%CI:0.770-0.868),验证集中ROC曲线的AUC=0.794(95%CI:0.717-0.870)。校准图和决策分析曲线提示模型具有良好的校准度和临床应用价值。超声+临床联合模型的预测效能高于单个模型。结论：我们基于超声检查结果和患者的临床资料构建了卵巢癌患者淋巴结转移的预测模型,在精准医疗的时代,可更准确地评估患者淋巴结转移的风险,并为患者制定最佳的治疗方案。     

宫颈癌患者淋巴结状态与预后的关系

目的分析宫颈癌患者淋巴结转移的特征及其对预后的影响。方法前瞻性研究手术治疗的宫颈癌患者311例,记录术中切除的淋巴结数量、部位、体积和病理结果,随访5年生存状况。结果 (1)311例患者淋巴结转移率23.8%,闭孔处转移率最高62.2%,主要沿宫旁淋巴结→闭孔→髂内、髂外→髂总→直肠旁→腹主动脉淋巴结引流途径顺次转移,3例为跳跃式转移。(2)在影响预后的多因素分析中,淋巴结转移(RR=3.524,95%CI:2.156-5.763)首先入选Cox回归模型。有、无淋巴结转移者的5年生存率分别为54.5%和86.1%(χ2=33.681,P<0.01)。(3)淋巴结转移个数和转移处数的风险比分别是2.441(95%CI:1.464-4.069)和2.484(95%CI:1.119-5.517),淋巴结转移数目≤3枚、4～10枚和>10枚者5年生存率分别是80.0%、57.6%和22.5%(χ2=14.340,P<0.01)。单处淋巴结转移和多处淋巴结转移者的5年生存率分别是72.0%和43.1%(χ2=5.887,P<0.05)。结论宫颈癌淋巴结转移主要沿淋巴引流途径进行,以闭孔处转移最常见。淋巴结转移状态是影响患者预后的最强因素,转移个数和转移处数越多,预后越差。     

人胃癌组织中Runx3表达水平与淋巴结转移的相关性研究

目的探讨胃癌组织中Runx3表达水平与淋巴结转移的关系。方法选取2018年1月至2019年1月在九江市第三人民医院经胃镜、病理活检确诊为胃癌并行手术治疗的患者30例为研究对象,根据患者淋巴结活检是否存在第2站及以上淋巴结转移分为未转移组(13例)、转移A组(7例,发生第2站淋巴结转移)和转移B组(10例,发生第2站以上淋巴结转移);采用反转录-聚合酶链反应(RT-PCR)检测30例胃癌患者胃癌组织中Runx3的表达水平,分析Runx3表达水平与淋巴结转移的相关性。结果未转移组、转移A组、转移B组患者胃癌组织中Runx3表达水平分别为0.787±0.227、0.583±0.135、0.362±0.040,3组比较,差异有统计学意义(F=7.425,P<0.05)。相关性分析结果显示,Runx3表达水平与胃癌淋巴结转移距离呈明显负相关(r=-0.993,P<0.05)。结论Runx3可作为判断胃癌患者是否存在淋巴结转移的检测指标,且其表达水平随着转移距离的增加而下降。     

临床诊断为局限性肾癌病例中区域淋巴结转移情况分析

目的分析临床诊断为局限性肾癌病例中区域淋巴结转移情况。方法回顾性研究1999年10月至2007年12月267例诊断为局限性。肾癌患者的资料。所有患者均通过CT扫描确定术前分期,采用AJCC2002年制定的TNM分期系统进行分期。分析术后病理证实有淋巴结转移患者的临床病理资料的特点及预后。结果267例临床诊断为局限性肾癌病例中有6例术后病理证实有区域淋巴结转移,其中T1aN1M0 1例,T1bN1M0 1例,T2N1M0 3例,T2N2M0 1例。6例均为透明细胞癌;核分级Ⅱ级1例,Ⅲ级1例,Ⅳ级4例;肿瘤直径4-10cm（平均7.7cm）;均为中央型肿物。清扫区域淋巴结后5例患者无瘤生存,1例于术后18个月死于复发转移。结论临床诊断为局限性肾癌病例病理证实为淋巴结转移者,多为高级别、中央型、体积较大的肾癌,区域淋巴结清扫后多数能无瘤生存。     

三阴性乳腺癌超声表现及其腋下淋巴结转移的相关危险因素

目的 探讨三阴性乳腺癌(TNBC)超声征象、临床病理特征及腋下淋巴结转移的相关危险因素.方法 回顾性分析2016年3月至2020年5月常州市第二人民医院收治的诊断为TNBC的105例女性患者的病例资料.所有病例均为单侧单发病灶,术前均行常规乳腺超声检查.根据病理结果,分为腋下淋巴结转移(LNM)组和腋下淋巴结未转移(N...     

大范围MRI扩散加权成像在食管、责门癌淋巴结微转移中的应用

目的探讨大范围磁共振扩散加权成像对食管、贲门癌术前分级及淋巴结转移的效果。方法35例食管癌术前行大范围MRI扩散加权成像,判定异常淋巴结数量及位置,与手术所见及术后病理结果对比。结果大范围MRI扩散加权成像发现淋巴结转移23例,病理结果转移18例,大范围MRI弥散成像无淋巴结转移12例,病理结果无转移9例;大范围MRI扩散加权成像、病理结果欠符合7例,总符合率80％,锁骨上和纵隔淋巴结符合率达82．8％,腹部淋巴结符合率55．6％。结论大范围MRI扩散加权成像对食管、贲门癌术前判断淋巴结转移较敏感,是食管、贲门癌术前评估淋巴结转移情况好方法,对直径〈0．5cm的淋巴结良恶性判定尚有不足。     

乳腺癌MRI影像学特征及其与前哨淋巴结和腋窝淋巴结转移的关系

目的  分析乳腺癌MRI影像学特征及其与前哨淋巴结和腋窝淋巴结转移的关系。方法  选择我院2019年5月~2022年5月收治的117例乳腺癌患者作为研究对象,其中前哨淋巴结结转移41例,腋窝淋巴结转移34例,无转移42例;对患者行乳腺癌MRI扫描检查;绘制ROC曲线分析诊断腋窝淋巴结转移和前哨淋巴结转移的价值。结果  乳腺癌前哨淋巴结转移、腋窝淋巴结转移患者MRI影像学检查的短长径比低于无转移者,相对表观扩散系数（rADC）值高于无转移,差异有统计学意义（P < 0.05）;乳腺癌前哨淋巴结转移、腋窝淋巴结转移和无转移患者环形强化情况的差异有统计学意义（P < 0.05）;乳腺癌MRI影像学特征联合应用预测前哨淋巴结模型为Log(P)=-0.602×短长径比+0.675×rADC-0.754×环形强化+0.895;乳腺癌MRI影像学特征联合应用预测腋窝淋巴结转移模型为Log(P)=-0.685×短长径比+0.712×rADC-0.695×环形强化+0.794;短长径比、rADC、环形强化三指标联合应用预测乳腺癌前哨淋巴结转移的AUC高于各指标单独应用,差异有统计学意义（P < 0.05）;短长径比、rADC、环形强化三指标联合应用预测腋窝淋巴结转移的AUC高于各指标单独应用,差异有统计学意义（P < 0.05）。结论  乳腺癌MRI影像学特征与前哨淋巴结和腋窝淋巴结转移高度相关,且MRI影像学特征联合应用可显著有效预测前哨淋巴结转移和腋窝淋巴结转移。     

超声检查在食管癌及淋巴结转移诊断中的价值

目的探讨超声在食管癌及淋巴结转移诊断中的价值。方法123例食管癌患者及90例健康人作为对照组,超声观察食管壁厚度、回声特点,常规扫查淋巴结及肝脏的转移情况。结果与病理结果比较,超声对颈段、胸段、腹段食管癌的检出率分别为95．2％、56．9％、93．3％,食管癌的管壁较对照组增厚（P〈0．05）,超声显示颈段、胸段、腹段食管癌食管周旁、颈部锁骨上窝及腹腔、转移淋巴结的诊断符合率分别为80％、55．3％、89．4％、98．7％及100％。结论超声检查对食管癌具有重要的诊断价值。     

结肠癌血清IGF-1水平及肿瘤组织中VEGF-C、VEGFR-3表达与淋巴结转移的相关性研究

目的探讨结肠癌血清胰岛素生长因子1(IGF-1)水平及肿瘤组织中血管内皮生长因子-C(VEGF-C)、血管内皮生长因子受体3(VEGFR-3)表达与微淋巴管生成以及淋巴结转移的相关性。方法收集60例结肠癌和60例结肠腺瘤患者血清样本和组织标本,分为结肠癌组和结肠腺瘤组,同一结肠癌组织标本癌旁正常组织作为癌旁正常组。另选取60例体检健康者作为健康组,健康组收集血清作为对照。比较各组血清IGF-1水平,组织中VEGF-C、VEGFR-3表达水平以及微淋巴管密度(LMVD)值,并分析其与结肠癌病理特征关系以及相互间关系。结果结肠癌组血清IGF-1水平显著高于结肠腺瘤组和健康组;结肠癌组中VEGF-C、VEGFR-3表达水平以及LMVD值均显著高于结肠腺瘤组和癌旁正常组,差异有统计学意义(P均<0.05);血清IGF-1水平,组织中VEGF-C、VEGFR-3表达水平以及LMVD值均与浸润程度和淋巴结转移有关,差异有统计学意义(P均<0.05),与性别、年龄无关,差异无统计学意义(P>0.05);IGF-1与VEGF-C、VEGFR-3及LMVD均呈正相关(r=0.68,r=0.66,r=0.55,P<0.05),VEGF-C和VEGFR-3与LMVD均呈正相关(r=0.60,r=0.62,P<0.05)。结论结肠癌血清IGF-1水平与组织VEGF-C、VEGFR-3阳性表达均明显上调,共同参与微淋巴管生成以及淋巴结转移,促进结肠癌发生发展。     

胸中下段食管鳞癌淋巴结转移趋势的研究

目的了解胸中下段食管鳞癌淋巴结转移趋势,探讨合理的淋巴结清扫范围。方法回顾性分析浙江省肿瘤医院胸腹外科收治的933例胸中下段食管鳞癌患者的临床及病理资料,应用χ^2检验进行样本率及构成比的比较。结果933例患者中517例经病理学证实存在淋巴结转移（转移率55．4％）,其中320例单独或合并存在腹腔淋巴结转移。全组总共清除淋巴结26118枚,转移2142枚（转移率8．2％）,其中腹腔淋巴结清除12072枚,转移906枚。不同分段食管鳞癌淋巴结转移方向分布不同（χ^2=7．90,0．01〈P〈0．05）,胸中段上行与下行转移的频度相当,胸下段下行转移多见,且胸下段腹腔淋巴结转移率及转移度均高于胸中段（χ^2=52．83,P〈0．01;χ^2=134．52,P〈0．01）。除7例Tis期食管鳞癌未发生淋巴结转移外,T,以后各期均可见淋巴结转移。不同T分期胸中下段食管鳞癌淋巴结转移方式分布不同（χ^2=18．12,0．05〈P〈0．01）,病变浸润越深,发生连续性转移的机会越多,而病变浸润越浅,发生跳跃性转移的机会越多。结论胸中下段食管鳞癌淋巴结清扫范围应参照淋巴结转移趋势,结合术前检查结果,合理地选择。同时,应重视腹腔淋巴结的清扫,尤其胸下段癌。