食管癌区域淋巴结转移模式：重新思考锁骨上淋巴结照射的临床靶区
Mapping patterns of nodal metastases in esophageal carcinoma: rethinking the clinical target volume for supraclavicular nodal irradiation.
作者信息
Luo Yijun, Liu Yuhui, Wang Xiaoli, Zhang Bin, Yu Jinming, Wang Chengang, Huang Yong, Li Minghuan
机构信息
School of Medical and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan 250117, China;; Department of Radiation Oncology and Radiology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan 250117, China.
Department of Radiology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan 250117, China.
出版信息
J Thorac Dis. 2016 Nov;8(11):3132-3138. doi: 10.21037/jtd.2016.11.96.
BACKGROUND
To map detail distribution of metastatic supraclavicular (SCV) lymph nodes (LN) in esophageal cancer (EC) patients and determine the precise radiation therapy clinical target volume (CTV).
METHODS
A total of 101 thoracic esophageal carcinoma patients after surgery experienced SCV LN metastasis were retrospectively examined. The SCV region is further divided into four subgroups. Using hand drawings registration, nodes were mapped to a template computed tomogram to provide a visual impression of nodal frequencies and anatomic distribution.
RESULTS
In all, 158 nodes were considered to be clinical metastatic in the SCV region in the 101 patients, 74 on the left and 84 on the right. Seven of 158 (4.4%) positive LN were located in group I, 78 of 158 (49.37%) were located in group II, 72 of 158 nodes (45.6%) were located in group III, 1 of 158 (0.63%) located in group IV.
CONCLUSIONS
According to our results, the SCV group II and group III are considered to be the high risk regions of esophageal squamous cell carcinoma (ESCC) LN metastasis, which were defined as elective nodal irradiation (ENI) areas.
背景
描绘食管癌（EC）患者锁骨上（SCV）转移淋巴结（LN）的详细分布，并确定精确的放射治疗临床靶区（CTV）。
方法
回顾性研究101例术后发生SCV LN转移的胸段食管癌患者。将SCV区域进一步分为四个亚组。采用手绘配准法，将淋巴结映射到模板计算机断层扫描图像上，以直观呈现淋巴结的频率和解剖分布。
结果
101例患者中，SCV区域共有158个淋巴结被认为有临床转移，左侧74个，右侧84个。158个阳性淋巴结中，7个（4.4%）位于I组，78个（49.37%）位于II组，72个（45.6%）位于III组，1个（0.63%）位于IV组。
结论
根据我们的结果，SCV II组和III组被认为是食管鳞状细胞癌（ESCC）LN转移的高危区域，应定义为选择性淋巴结照射（ENI）区域。
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