Schröder W, Baldus S E, Mönig S, Zirbes T K, Dienes H P, Hölscher A H
Klinik und Poliklinik für Visceral- und Gefässchirurgie, Universität zu Köln, Joseph-Stelzmann Str. 9, 50931 Köln.
Langenbecks Arch Chir Suppl Kongressbd. 1998;115(Suppl I):501-3.
In 22 patients with thoracoabdominal esophagectomy and 2-field lymphadenectomy the lymph nodes (LN) were dissected according to a standardized protocol and classified in five groups regarding their size. 407 of 675 dissected LN (60.3%) were < 5 mm. 89.4% of the metastatic LN were < 10 mm although LN > 10 mm showed significantly more metastases than LN < 10 mm. Since diagnostic imaging defines metastatic LN by a diameter > 10 mm these results demonstrate the inaccuracy to evaluate preoperatively the cN-status. These results also support the need of a systematic lymphadenectomy in patients with esophageal cancer.
在22例行胸腹段食管癌切除术及二野淋巴结清扫术的患者中,按照标准化方案对淋巴结(LN)进行清扫,并根据其大小分为五组。675个清扫的淋巴结中有407个(60.3%)直径小于5mm。89.4%的转移淋巴结直径小于10mm,尽管直径大于10mm的淋巴结转移明显多于直径小于10mm的淋巴结。由于诊断性影像学检查将直径大于10mm的淋巴结定义为转移淋巴结,这些结果表明术前评估cN状态不准确。这些结果也支持了食管癌患者进行系统性淋巴结清扫的必要性。