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食管鳞状细胞癌中沿胃左动脉的淋巴结转移的预后影响

Prognostic impact of lymph node metastasis along the left gastric artery in esophageal squamous cell carcinoma.

作者信息

Liu Xuan, Wu Leilei, Zhang Dongkun, Lin Peng, Long Hao, Zhang Lanjun, Ma Guowei

机构信息

Department of thoracic surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangdong Esophageal Cancer Institute, 651 Dongfengdong Road, Guangzhou, 510060, China.

Department of Thoracic Surgery, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.

出版信息

J Cardiothorac Surg. 2021 May 3;16(1):124. doi: 10.1186/s13019-021-01466-2.

Abstract

BACKGROUND

Although the incidence of lymph node (LN) metastasis (LNM) along the left gastric artery is high, its relationship with the prognosis in postoperative patients with esophageal squamous cell carcinoma (ESCC) is rarely reported. This study clarified the prognostic impact of LNM along the left gastric artery in postoperative patients with ESCC.

METHODS

This study assessed data of 1521 patients with ESCC who underwent esophagectomy at the Sun Yat-sen University Cancer Center between March 1992 and March 2012. A chi-squared test and Mann-Whitney U test were used to explore the preliminary correlation between clinical factors and LNM along the left gastric artery. Univariate and multivariate Cox regression analyses were used to assess whether LNM along the left gastric artery was an independent predictor of overall survival. Kaplan-Meier analysis and the log-rank test were used to present a classifying effect based on LN status.

RESULTS

LNM was observed in 598 patients (39.3%) and was found along the branches of the left gastric artery in 256 patients (16.8%). The patients were classified into two groups based on the presence of LNM along the left gastric artery. Patients without LNM along the left gastric artery had better cancer-specific survival than those with positive LNs (P <  0.001).

CONCLUSIONS

This study indicated that LNM along the left gastric artery was an important independent prognostic factor for long-term survival among ESCC patients (P = 0.011).

摘要

背景

尽管沿胃左动脉发生淋巴结转移(LNM)的发生率很高,但在食管鳞状细胞癌(ESCC)术后患者中,其与预后的关系鲜有报道。本研究阐明了胃左动脉旁淋巴结转移对ESCC术后患者预后的影响。

方法

本研究评估了1992年3月至2012年3月间在中山大学肿瘤防治中心接受食管癌切除术的1521例ESCC患者的数据。采用卡方检验和Mann-Whitney U检验探讨临床因素与胃左动脉旁淋巴结转移的初步相关性。采用单因素和多因素Cox回归分析评估胃左动脉旁淋巴结转移是否是总生存的独立预测因素。采用Kaplan-Meier分析和对数秩检验根据淋巴结状态呈现分类效果。

结果

598例患者(39.3%)发生了淋巴结转移,其中256例患者(16.8%)的转移发生在胃左动脉分支处。根据胃左动脉旁淋巴结转移情况将患者分为两组。胃左动脉旁无淋巴结转移的患者比有阳性淋巴结转移的患者具有更好的癌症特异性生存(P < 0.001)。

结论

本研究表明,胃左动脉旁淋巴结转移是ESCC患者长期生存的重要独立预后因素(P = 0.011)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04c9/8091502/d43ce931fccd/13019_2021_1466_Fig1_HTML.jpg

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