Department of Frontier Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
Surg Today. 2011 Sep;41(9):1190-5. doi: 10.1007/s00595-011-4542-y. Epub 2011 Aug 26.
The revision of the TNM Classification of Malignant Tumors, 7th Edition, suggests the lymph node (LN) status to be the most significant risk factor in esophageal cancer. This article reviews the current status of LNs as indicators of prognosis. The significance of the number of metastatic LNs, the number of resected LNs, and a novel index, the "LN ratio" (metastatic LNs/removed LNs) in patients with esophageal cancer, were reviewed. The number of metastatic LNs independently predicted the prognosis of both overall survival and relapse-free survival. The number of positive LNs was also the best predictive marker of survival. Furthermore, overall survival significantly depended on the number of surgically removed LNs, and the LN ratio closely correlated with survival. The LN status is considered to be the most significant information that can be used to predict the prognosis. However, there are many issues that still need to be resolved. Better knowledge of the N-status is therefore needed to effectively utilize this information. Further research should focus on the N-status of patients with esophageal cancer.
第七版《恶性肿瘤 TNM 分类》修订版建议将淋巴结（LN）状态作为食管癌最重要的危险因素。本文综述了目前作为预后指标的 LNs 的状况。本文回顾了食管癌患者中转移性淋巴结数量、切除淋巴结数量和新指标“淋巴结比率”（转移性淋巴结/切除淋巴结）的意义。转移性淋巴结数量独立预测了总生存和无复发生存的预后。阳性淋巴结数量也是生存的最佳预测标志物。此外，总生存明显取决于手术切除的淋巴结数量，淋巴结比率与生存密切相关。淋巴结状态被认为是预测预后最重要的信息。然而，仍有许多问题需要解决。因此，需要更好地了解 N 状态，以便有效地利用这些信息。进一步的研究应集中在食管癌患者的 N 状态上。
