胸段食管癌淋巴结转移规律的探讨

目的:探讨胸段食管癌淋巴结转移规律及影响淋巴结转移的因素。方法:对140例胸段食管癌临床资料进行分析和统计学处理。结果:胸上段食管癌主要向颈部淋巴结转移;胸中段食管癌主要向颈部、纵隔、腹部淋巴结转移;胸下段食管癌主要向纵隔、腹部淋巴结转移;各段食管癌均存在淋巴结跳跃性转移;各段食管癌淋巴结转移度无显著性差异(P>0.05);鳞状细胞癌与腺癌、低分化癌之间,肿瘤长度之间淋巴结转移率无显著性差异(P>0.05),浸润深度之间淋巴结转移率有显著性差异(P<0.01)。结论:胸段食管癌淋巴结转移与浸润深度相关,与肿瘤长度,细胞分化程度无关;跳跃性淋巴结转移是食管癌淋巴结转移的一个特点。

The Study on Metastasis of Lymph node for Carcinoma of the Thoracic Esophagus

Objective: To study the pattern of lymph node metastasis in thoracic esophageal carcinoma and to analyze the factors influencing lymph node metastasis and the metastasis direction. Methods: The clinical materials of 140 patients having undergone radical resection on the carcinoma of thoracic esophagus were retrospectively analyzed. Results: The factors influencing lymph node metastasis were depth of tumor invasion and length of tumor, while style of pathology did not influence lymph node metastasis. As to metastatic direction, carcinoma of superior thoracic esophagus was mainly regional and cervical lymph node; intermediate thoracic esophageal carcinoma was regional and extended vertically; carcinoma of lower thoracic esophagus was mainly abdominal lymph node and mediastinal lymph node, with leaping-over metastasis. Conclusions: Lymph node metastasis relates to depth of tumor invasion but not the length of tumor and differentiation of cells. Every segmental esophageal carcinoma has its own opposite direction of lymph node metastasis. To widely dissect regional lymph node and enough length of esophagus, the cervical lymph node dissection will be necessary for superior and middle thoracic esophageal carcinoma; abdominal and mediastinal lymph node dissection is suitable for lower thoracic esophageal carcinoma.