摘要
目的对腺癌侵及食管壁深度与淋巴结转移的关系以及淋巴结转移对预后的影响进行分析研究。方法澳大利亚弗林德斯大学医学中心自1985年～2003年,手术治疗食管腺癌121例。其中男101例,女20例。年龄36～80岁,平均62岁。本组手术切除率为96.7%(117/121例)。手术清扫淋巴结的数目每例为2～30个,平均8个。无淋巴结转移59例(48.8%)、有淋巴结转移62例(51.2%)。本组病例全部得到随访。结果当肿瘤位于黏膜层或黏膜下层(T1)时,淋巴结转移的发生率为22.2%(10/45例)、平均淋巴结转移的个数为0.3个、>4个淋巴结转移的比例为0(0/45例);当肿瘤侵及食管周围组织(T4)时,淋巴结转移的发生率为85.7%(6/7例)、平均淋巴结转移的个数为5.1个、>4个淋巴结转移的比例为71.4%(5/7例),P<0.05。无淋巴结转移组的5年生存率为52.9%、1～4个淋巴结转移组的5年生存率为11.5%、>4个淋巴结转移组的5年生存率为0,P<0.01。结论肿瘤对食管壁侵及深度和淋巴结转移的发生率及淋巴结转移的数量之间存在正相关性。随着肿瘤对食管壁侵及深度的增加,淋巴结转移的发生率、平均淋巴结转移的数量和>4个淋巴结转移的比例均增加。有无淋巴结转移和淋巴结转移的数量是影响远期生存率的一个重要因素。
Objective This study analyzed the relationship between tumor depth and lymph node metastasis of esophageal adenocareinoma. Methods The study group comprised 121 patients with esophageal adenoeareinoma who underwent an attempted esophagectomy between 1985 and 2003. Overall, there were 101 male and 20 female patients with a mean age at surgery of 62 years （range 36- 80）. The overall resection rate was 96.7 % （ 117/121 ）. The number of nodes removed were 8 （range 2 ～ 30）. Lymph nodes sta- tus were that negative nodes 59 （48.8%） and local node metastases 62 （51.2%）. All of the patients were followed up. Results When tumor invaded mucosa or submucosa of the esophagus （T1）, the lymph node metastasis rate was 22.2% （ 10/45）, mean number of the lymph node metastasis was 0.3, and the proportion of more than 4 lymph node metastasis was 0（0/45）. When tumor invasded adjacent structures of the esophagus （T4）, the lymph node metastasis rate was 85.7% （6/7）, mean number of the lymph node metastasis was 5.1, and the proportion of more than 4 lymph node metastasis was71.4 % （5/7）, P 〈 0.01. The 5-year survival was 52.9 % in the group without node metastases, 11.5 % in the group of 1～4 node metastases, and was 0 in the group of more than 4 node metastases, P 〈 0.01. Condusion There was a direct proportion between the tumor depth and lymph node metastasis of the esophageal adenocareinoma. The deeper of the tumor invasded, the rate of lymph node metastases, mean number of node metastases, and the proportion of more than 4 node metastases increased. Lymph node metastases and the number of node involved are the important factors that effect survival rate.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2006年第5期302-304,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
食管肿瘤
腺癌
肿瘤转移
肿瘤分期
淋巴结
Esophageal neoplasms
Adenocarcinoma
Neoplasm metastasis
Neoplasm staging
Lymph nodes
