Asakura Takanobu, Hashimoto Takashi, Ando Takao, Tomita Natsumi, Matsumoto Toshiharu, Arakawa Atsushi, Tsurumaru Masahiko, Kajiyama Yoshiaki
Juntendo Iji Zasshi. 2022 Aug 1;68(4):363-368. doi: 10.14789/jmj.JMJ21-0041-OA. eCollection 2022.
The goal of the study was to examine the relationships among micrometastasis, pathological degree of differentiation and survival in patients with esophageal squamous cell carcinoma (SCC).
A single-center retrospective study of patients diagnosed with thoracic esophageal SCC.
Immunostaining using CK13 was carried out for all lymph nodes resected by radical esophagectomy with three-field lymphadenectomy. The relationships among micrometastasis to lymph nodes, degree of differentiation and survival were investigated.
The 25 patients included 14 (56.0%) well-differentiated and 11 (44.0%) moderately differentiated cases. In multivariate analysis, well-differentiated cases were not related to micrometastasis (odds ratio (OR): 1.5, confidence interval (CI): 0.2-12, p=0.7). In multivariate analysis of survival, cases in pStage III or higher were likely to have shorter survival (hazard ratio (HR): 2.8, CI: 0.7-12, p=0.16), and those with micrometastasis also tended to have shorter survival (HR: 2.7, CI: 0.8-9, p=0.11)); however, well-differentiated cases were not significantly related to survival (HR: 1.5, CI: 0.4-5.5, p=0.5).
Micrometastasis to lymph nodes may be a prognostic factor even in advanced esophageal cancer. The degree of differentiation was not related to micrometastasis or survival.
本研究的目的是探讨食管鳞状细胞癌（SCC）患者微转移、病理分化程度与生存之间的关系。
对诊断为胸段食管SCC的患者进行单中心回顾性研究。
对所有通过根治性食管切除术加三野淋巴结清扫术切除的淋巴结进行CK13免疫染色。研究淋巴结微转移、分化程度与生存之间的关系。
25例患者中，14例（56.0%）为高分化，11例（44.0%）为中分化。多因素分析显示，高分化病例与微转移无关（优势比（OR）：1.5，置信区间（CI）：0.2 - 12，p = 0.7）。在生存的多因素分析中，pStage III期或更高分期的病例生存时间可能较短（风险比（HR）：2.8，CI：0.7 - 12，p = 0.16），有微转移的病例生存时间也往往较短（HR：2.7，CI：0.8 - 9，p = 0.11）；然而，高分化病例与生存无显著相关性（HR：1.5，CI：0.4 - 5.5），p = 0.5）。
即使在晚期食管癌中，淋巴结微转移也可能是一个预后因素。分化程度与微转移或生存无关。
