淋巴结微转移是pNo食管鳞癌病人术后早期复发的危险因素

目的 探索病理检查无淋巴结转移的食管鳞癌病人中淋巴结微转移的发生率并评价淋巴结微转移对预后的影响.方法 应用PT-PCR,对93例食管鳞癌术后病理诊断阴性的426站区域淋巴结进行进一步研究,检测MUCI基因mRNA的表达,从而诊断淋巴结微转移.对病人随访,Log-rank 检验比较无病间隔期,Cox回归多因素分析判定独立的预后因素.结果 32例(34.4%)的40站区域淋巴结中(9.4%)检测到MUCI基因mRNA的表达.无病间隔期与淋巴结微转移显著相关(P=0.0138).淋巴结微转移者的5年生存率显著低于无淋巴结微转移者(P=0.004).Cox回归多因素分析的结果显示T分期及淋巴结微转移是独立的预后因素.结论 病理检查无淋巴结转移的食管鳞癌病人中淋巴结微转移的发生率为34.4%.无病间隔期与淋巴结微转移显著相关,T分期及淋巴结微转移是独立的预后因素.

Lymph node micrometastasis:a predictor of early tumor relapse after complete resection of histologically node-negative esophageal cancer

Objective To investigate the prevalence of lymph node micrometastasis (LNMM) baeed on the detection of MUCI mRNA and the impact of these micrometastases on disease-free interval after resection of pathologic No(pNo) esophageal squamous cell cabcer(ESCC).Methods The sujects were 93 patients who underwent complete resection of pNo ESCC at our department between January , 1999 and January 2001.All lymph nodes(426 ststions) obtained from these patients were reevluated by RT-PCR to detect MUC1 mRNA .The diagnosis of LNMM was based on the detection of Muc1 mRNA.Log-rank test was perfomed to compare the dis- ease-free interval and Cox regression multivariate analysis was performed to determine independent prognostic factoas.Results Micro-metastasis was detected in 40 lymph node stations (9.4%) from 32 patients(34.4%).Disease-free interval was significantly aseoci-ated with LNMM (P=0.0138).The 5-year survival rate of patients with LNMM was significantly lower than that of thos without LNMM (P=0.004).The results of multivariate analysis confirmed that T status and LNMM were independent prognostic factors. Concluslon The prevalence of LNMM in patients with PNo ESCC was 34.4%(32/93).Thus,LNMM was significantly associated With disease-free interval.T status and LNMM were both independnt prognostic factons.