摘要
目的探讨胸段食管癌淋巴结转移规律及三区域淋巴结清扫术与预后的关系。方法对262例胸段食管癌采用颈、胸、腹三区域淋巴结清扫术。结果全组262例共清扫淋巴结5766枚,平均22枚/例,其中749枚见淋巴结转移,全组152例有淋巴结转移,转移率58.1%。胸上段食管癌淋巴结转移方向主要向中上纵隔及颈部,中段癌颈、胸、腹三区域皆可转移。胸下段癌主要向中下纵隔及腹部转移。结论胸段食管癌的预后与肿瘤的浸润深度、生物学特性、淋巴结转移个数及范围等因素密切相关。胸上段、中段癌可选择颈、胸、腹三区域淋巴结清扫术,胸下段癌慎选该术式。该术式有利于提高手术根治率及临床病理分期的准确性,从而延长患者的生存率,特别是少数淋巴转移患者的生存率。
Objective To explore the rule of lymph node metastasis for thoracic esophageal carcinoma and the relationship between the extended three -field lymph node dissection and outcome. Methods 262 patients with thoracic esophageal carcinoma underwent extended three -field （cervical, thoracic and abdominal） lymph node dissection. Results 5766 lymph nodes had been resected, 22 lymph nodes per patient average. And 749 positive lymph nodes were detected, lymph node metastasis occurred in 152（ 152/262 58.1% ） cases. Superior thoracic esophageal carcinoma were prone to have lymph node metastasis in upper - mediastinum, mid - mediastinum and cervix. Midpiece thoracic esophageal carcinoma were prone to have three -field （cervical, thoracic and abdominal） lymph node metastasis. Inferior thoracic esophageal carcinoma were prone to have lymph node metastasis in mid - mediastinum,inferior mediastinum and abdomen. Conclusion the outcome is concerned with depth of invasion, histological type, lymphatic invasion. The extended three - field lymph node dissection should be recommended for superior and midpiece thoracic esophageal carcinonm, while should be used judiciously for inferior thoracic esophageal carcinoma. It may help increase radical resection rate and the accuracy of surgical stage for thoracic esophageal carcinoma. And this will improve the long- term survival , especially for patients with positive lymph nodes.
出处
《安徽医学》
2010年第5期468-470,共3页
Anhui Medical Journal
关键词
食管癌
淋巴结转移
三区域淋巴结清除术
预后
Esophageal carcinoma
Lymph node metastasis
Tree- field lymph node dissection
Prognosis
