胸段食管鳞癌胸腹部淋巴结转移相关因素研究

目的]探讨胸段食管鳞癌胸腹部淋巴结转移的相关因素。方法]回顾性分析612例胸段食管鳞癌患者的临床病理学资料与胸腹部淋巴结转移的关系,应用χ2检验进行单因素分析,应用Logistic回归分析进行多因素分析。结果]淋巴结转移患者322例,转移率52.6%。清扫淋巴结16513枚,转移1128枚,转移度6.8%。胸部淋巴结转移245例,转移率40%。胸部淋巴结清扫总数8510枚,转移639枚,转移度7.5%。腹部淋巴结转移191例,转移率31.2%。腹部淋巴结清扫总数7765枚,转移458枚,转移度5.9%。Logistic回归分析提示,脉管瘤栓、腹部淋巴结转移、T分期、胸部淋巴结清扫数、分级、病变长度以及年龄是胸部淋巴结转移的独立危险因素,脉管瘤栓、贲门受侵、胸部淋巴结转移数、部位、腹部淋巴结清扫数以及病变长度是腹部淋巴结转移的独立危险因素。结论]胸段食管鳞癌淋巴结清扫应该参照淋巴结转移的危险因素,合理地进行清扫。

The Correlation Factors of Thoracic or Abdominal Lymphatic Metastasis in Thoracic Esophageal Squamous Cell Carcinoma

Purpose] To study the correlation factors of thoracic or abdominal lymphatic metastasis in thoracic esophageal squamous cell carcinoma. Methods] The relationship between clinico-pathologic factors of thoracic or abdominal lymphatic metastasis in 612 cases with thoracic esophageal squamous cell carcinoma was retrospectively analyzed by univariate analysis with χ2 test and multivariate analysis with Logistic regression. Results] Lymphatic metastasis was found in 322 cases（52.6%）,245 cases（40%） in thorax,and 191 cases （31.2%） in abdomen. Of the 16513 excised lymph nodes,metastasis was found in 1128 （6.8%） nodes,8510 lymph nodes in thorax with 639 metastasis （7.5%）,and 7765 lymph nodes in abdomen with 458 metastasis （5.9%）. Logis-tic regression showed that vessel invasion,abdominal lymphatic metastasis,T stage,the number of thoracic lymph nodes,grade,tumor length,and age were independent risk factors of thoracic lym-phatic metastasis; vessel invasion,cardia invasion,the metastasis number of thoracic lymph nodes,location,the number of abdomen lymph nodes,and tumor length were independent risk factors of abdomen lymphatic metastasis. Conclution] Lymph node dissection should consult to the risk factors of lymph nodes metastasis in thoracic esophageal squamous cell carcinoma.