食管上中段癌淋巴结转移特点及临床意义

目的　了解食管上中段鳞癌淋巴结转移特点及对预后的影响 ,探讨合理的淋巴结清扫范围。　方法　对 90例经手术根治性切除及病理证实的食管上中段鳞癌的临床资料进行回顾性分析。　结果　淋巴结转移率 5 6 .7% ,转移度 11.2 % ,影响淋巴结转移的因素为肿瘤浸润深度及分化 ;有淋巴结转移者 5年生存率 (9.80 % )明显低于无淋巴结转移(43.5 8% ) (P<0 .0 1)。　结论　食管上中段癌淋巴结转移表现为上、下双向性及远距离纵轴扩散的特点 ,淋巴结转移程度是食管癌根治术后最重要的预后因素 ,对病期较早的食管癌病例应适当扩大淋巴结清扫范围 ,选择“三野”淋巴结清扫术。

Characteristic of Lymph Node Metastasis of Squamous Cell Carcinoma of up-and mid-Esophagus and Its Clinical Value

Objective To find out the lymph node metastasis character of the up|and mid|section esophagus squamous cell carcinoma and study about the clear away lymph node range. Methods Retrospective studies about 90 squamous cell carcinoma of the up|and mid|section esophagus cases which had been radical cut and pathological confirm. Results Lymph node metastasis rate is 56.7% and metastasis degree is 11.2%. The erosive depth and differentiation are the main factors. And the 5 year survival rate of one with lymph node metastasis(9 80%) is obviously lower than that without lymph node metastasis(43 58%)(P<0 01). Conclusion The lymph node metastasis character is bi|direction(upward and downward) and long distance longitudinal diffuse. The lymph node metastasis degree affects predictive results most. And the best way for early esophagus carcinoma patient is clear away "three field" lymph nodes.;