Ma Zhao, Chen Chuangui, Duan Xiaofeng, Liu Xiaoqiong, Gong Lei, Yu Zhentao
Department of Esophageal Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China.
Department of Esophageal Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China; Email:
Zhonghua Wai Ke Za Zhi. 2015 Jul 1;53(7):513-7.
To analyze the pattern and the clinicopathologic risk factors of lymph node metastasis (LNM) in pN1 stage esophageal squamous cell carcinoma.
Clinical data of 181 patients (154 male and 27 female patients, aging from 38 to 84 years) who underwent esophagectomy during January 2005 and December 2008 were reviewed, including 69 cases through left thoracotomy and 112 cases through right thoracotomy. All patients underwent systematic lymphadenectomy. The risk factors related to lymph node metastasis were analyzed by χ² test and Logistic regression analysis.
The relatively highest LNM site were middle and lower thoracic paraesophageal (38.4%), right and left cardiac (35.3%) and the left gastric artery (38.8%). The LNM of middle and lower thoracic paraesophageal was correlated with T stage (χ² =11.754, P=0.009). A correlation was also found among the LNM of upper mediastinum and the location of tumor (P=0.039). The T stage (χ² =8.694, P=0.034) and TNM stage (χ² =6.906, P=0.032) were the risk factors of the LNM of middle and lower mediastinum. The risk factors of the LNM of abdomen were the location of tumor, the length of tumor, T stage and TNM stage (χ² =5.713 to 16.749, P>0.05). Multivariate analysis showed that the location of tumor is the independent risk factors for the abdominal lymph node metastasis.
The relatively highest LNM sites are correlated with the location of tumor, T stage, the length of tumor and TNM stage. According to the risk factors of LNM, the relatively highest LNM sites should be mainly swept.
分析pN1期食管鳞状细胞癌淋巴结转移（LNM）的模式及临床病理危险因素。
回顾性分析2005年1月至2008年12月期间行食管切除术的181例患者（男性154例，女性27例，年龄38～84岁）的临床资料，其中经左胸入路69例，经右胸入路112例。所有患者均行系统性淋巴结清扫术。采用χ²检验和Logistic回归分析与淋巴结转移相关的危险因素。
LNM相对高发部位为胸段食管中下段旁（38.4%）、左右贲门（35.3%）和胃左动脉旁（38.8%）。胸段食管中下段LNM与T分期相关（χ² =11.754，P=0.009）。上纵隔LNM与肿瘤位置也存在相关性（P=0.039）。T分期（χ² =8.694，P=0.034）和TNM分期（χ² =6.906，P=0.032）是胸段食管中下段LNM的危险因素。腹部LNM的危险因素为肿瘤位置、肿瘤长度、T分期和TNM分期（χ² =5.713～16.749，P>0.05）。多因素分析显示肿瘤位置是腹部淋巴结转移的独立危险因素。
LNM相对高发部位与肿瘤位置、T分期、肿瘤长度和TNM分期相关。根据LNM的危险因素，应重点清扫LNM相对高发部位。
