揭阳地区食管鳞癌病理形态及淋巴结转移分析

目的:分析揭阳地区食管鳞癌(ESC)病理形态特点及与淋巴结转移的关系.方法:对揭阳市人民医院1346例手术切除食管鳞癌标本行回顾性研究.结果:本地区ESC多发于中下段,以中老年为主,大部分中晚期发现,髓质及溃疡型多见,分化程度偏低,全组淋巴结转移率43.2%(581/1346);淋巴结转移率与肿瘤部位、分型、分期、分化有关(P＜0.05).结论:ESC在本地区大多发现较晚,且分化程度低、淋巴结转移率较高,早期发现是本地区一大难题,普查可在本地区进一步摧广.结合本地区上段ESC偏少情况,淋巴结多广泛转移及转移率较高等特点,三野清扫已无较大意义;对中下段ESC可行二野(胸腹二野)淋巴结清扫并配合放疗,可提高5年生存率及大幅提高患者生活质量.

Analysis of Esophageal Squamous Carcinoma Morphology and Lymphatic Metastasis in Jieyang area

Objective: To analyze the morphologic characteristics and the relationship of esophageal carcinoma in Jieyang area.Method:1346 cases resected esophageal squamous carcinoma in people's hospital of Jieyang city were studied retrospectively.Result: In this area,most cases of ESC located in middle and lower portion of esophagus,mainly happened in middle and old age persons,most cases belonged to middle or late stages,medullary and ulcerative type were most common and degree of differentiation were low.The whole group lymph node metastatic rate were 43.2%(581/1346 cases),the lymph node metastatic rate related to location,tumor typing,staging and differentiation(P<0.05).Conclusion: ESC in this area most cases belongs to late stage and low differentiation with high lymph node metastatic rate,early detection become a most difficult question,generalized early detection worth spreading in this area,combined with rare ESC in upper segment of esophagus,and characteristic if lymph node high metastatic rate the three area clean up operation become un-meaningful for middle and lower portion ESC can use double field(thoracic and abdomen),radical lymph node clean up combine with radiotherapy can promote 5 years survive rate and life quality of patients.