杨月阳, 弓磊, 唐鹏, 马明全, 张洪典, 马钊, 王海通, 朱恺, 于振涛. 56例同时性多原发食管鳞癌淋巴结转移因素分析[J]. 中国肿瘤临床, 2020, 47(4): 181-186. DOI: 10.3969/j.issn.1000-8179.2020.04.292
引用本文: 杨月阳, 弓磊, 唐鹏, 马明全, 张洪典, 马钊, 王海通, 朱恺, 于振涛. 56例同时性多原发食管鳞癌淋巴结转移因素分析[J]. 中国肿瘤临床, 2020, 47(4): 181-186. DOI: 10.3969/j.issn.1000-8179.2020.04.292
Yueyang Yang, Lei Gong, Peng Tang, Mingquan Ma, Hongdian Zhang, Zhao Ma, Haitong Wang, Kai Zhu, Zhengtao Yu. Characteristics and risk factors of lymph node metastasis in 56 synchronous multiple primary esophageal squamous cell carcinoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2020, 47(4): 181-186. DOI: 10.3969/j.issn.1000-8179.2020.04.292
Citation: Yueyang Yang, Lei Gong, Peng Tang, Mingquan Ma, Hongdian Zhang, Zhao Ma, Haitong Wang, Kai Zhu, Zhengtao Yu. Characteristics and risk factors of lymph node metastasis in 56 synchronous multiple primary esophageal squamous cell carcinoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2020, 47(4): 181-186. DOI: 10.3969/j.issn.1000-8179.2020.04.292

56例同时性多原发食管鳞癌淋巴结转移因素分析

Characteristics and risk factors of lymph node metastasis in 56 synchronous multiple primary esophageal squamous cell carcinoma

  • 摘要:
      目的  探讨同时性多原发食管鳞癌(synchronous multiple primary esophageal squamous cell carcinoma,SMESC)淋巴结转移的特点及预后因素。
      方法  收集2011年1月至2018年12月收治的56例SMESC患者的临床病例资料,回顾分析各部位的淋巴结转移率,研究不同癌灶浸润深度、长度等因素对淋巴结转移的影响。
      结果  56例SMESC患者中34例有淋巴结转移,淋巴结转移率为60.7%,颈部、上、下纵隔和腹部的淋巴结转移率分别为16.7%、34.7%、32.7%和38.2%。不同癌灶部位淋巴结转移规律不同,但在上、下纵隔及腹部均有广泛转移。单因素分析结果显示,淋巴结转移与癌灶长度及浸润深度有关(P < 0.05)。多因素分析结果表明,原发癌灶浸润深度和清扫淋巴结数目是淋巴结转移的独立预后因素。
      结论  食管癌McKeown术式及系统淋巴结清扫是目前治疗SMESC的最佳治疗手段。

     

    Abstract:
      Objective  To investigate characteristics and risk factors of lymph node metastasis in synchronous multiple primary esophageal squamous cell carcinoma.
      Methods  Data of 56 patients with synchronous multiple primary esophageal squamous cell carcinoma who underwent surgery in Tianjin Medical University Cancer Institute & Hospital, during a period from January 2011 to December 2018, were collected. The lymph node metastasis rate at different sites was retrospectively analyzed. The depth of tumor infiltration, tumor length at different sites and other factors were analyzed to assess their influences on lymph node metastasis.
      Results  Of the total 56 patients with synchronous multiple primary esophageal squamous cell carcinoma, 34 suffered from lymph node metastasis, and the total nodal metastasis rate was 60.7%. And the lymph node metastasis rates in cervical, upper mediastinum, lower mediastinum and abdomen were 16.7%, 34.7%, 32.7% and 38.2%, respectively. The lymph node metastasis patterns varied based on different cancer sites. But lymph node metastasis was always observed in the areas of upper mediastinum, lower mediastinum and along with the abdomen. The results from univariate analysis showed that the lymph node metastasis was associated with length of the tumor and depth of infiltration at each tumor site (P < 0.05). The results from multivariate analysis showed that the depth of tumor infiltration at the primary tumor site and harvested lymph node numbers were the independent prognostic factors for the nodal metastasis.
      Conclusions  McKeown resection with systematic lymph node dissection is the best option for treating synchronous multiple primary esophageal squamous cell carcinoma.

     

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