摘要
目的探讨食管鳞癌患者淋巴结转移的特征、影响因素及其对生存的影响,为指导临床规范治疗提供依据。方法对299例食管鳞癌根治术患者的临床病理资料进行回顾性分析。结果 (1)不同肿瘤部位、最长径、T分期,淋巴结转移差异均有统计学意义(均P<0.05),淋巴结转移率由高到低依次是胸下段、胸中段、胸上段,随肿瘤最长径、T分期增高而增高。(2)肿瘤最长径<3 cm和3~5 cm;Tis+T1期和T2期淋巴结转移风险较小(均P<0.05)。(3)本组患者1、3、5年生存率分别为87%、69%和49%。N0、N1患者生存期显著优于N3患者(均P<0.05)。分层生存期成对比较,N0患者生存最好,N3最差。(4)G2期患者死亡风险是G1期的2.168倍;N3期患者死亡风险是N0期的3.57倍。结论食管鳞癌患者淋巴结转移与肿瘤部位、最长径和T分期有关;肿瘤最长径大和高T分期淋巴结转移风险较大;分化较差、淋巴结转移数多,患者预后较差。
Objective To investigate the characteristics and influence factors of lymph node metastasis（LNM） and its effect on the survival of esophageal squamous cell carcinoma（ESCC） patients, to provide the evidence for guiding standard clinical treatment. Methods We retrospectively analysed clinicopathological characteristics of 299 ESCC patients. Results （1）The difference of LNM in tumor site, the longest diameter and T staging were significantly different（all P〈0.05）. The rate of LNM from high to low was the lower, the middel and the upper thoracic segment in turn, and it was increased with the increase of tumor＇s longest diameter and T stage. （2） The longest diameter 〈3cm and 3-5cm, Tis＋T1 stage and T2 stage were with less risk of LNM（all P〈0.05）. （3） The 1-, 3-, 5-year survival rates were 87%, 69% and 49%, respectively. The survival period of N0 and N1 patients were superior to N3 patients significantly（all P〈0.05）. As to the pairwise comparison of survival period in each layer, the NO patients had better survival, and the N3 patients had the worst. （4） The death risk of G2 patients was 2.168 times compared to G1 patients, and that of N3 patients was 3.57 times compared to NO patients. Conclusion LNM is related to tumor location, the longest diameter and T staging in ESCC patients. Larger tumor longest diameter and higher T staging are with higher risk of LNM. The patients with poor differentiation and LNM have poor prognosis.
出处
《肿瘤防治研究》
CAS
CSCD
北大核心
2017年第6期413-417,共5页
Cancer Research on Prevention and Treatment
关键词
食管鳞癌
淋巴结
影响因素
生存分析
Esophageal squamous cell carcinoma
Lymph node
Influence factor
Survival analysis
