术前胸中上段食管癌颈部淋巴结转移相关因素分析

doi:10.3969/j.issn.1005-6483.2019.07.008

摘要/Abstract

摘要： 目的：分析术前胸中上段食管癌病人发生颈部淋巴结转移的相关因素。方法：行食管癌切除+三野淋巴结清扫手术的食管胸中上段癌病人64例，按照是否发生颈部淋巴结转移分为转移组（20例）和未转移组（44例）。比较两组病人的术前临床资料，分析发生颈部淋巴结转移的独立危险因素。结果：食管癌病人超声检查结果中淋巴结短径、纵横比、内部回声、RI值与是否发生颈部淋巴结转移关系密切（P<0.05）；在两组病人的增强CT结果中，发生喉返神经旁淋巴结、胸部淋巴结肿大的比率差异明显，差异有统计学意义（P<0.05）；短径、RI值诊断颈部淋巴结转移的效能较好，ROC曲线下面积分别为0.823、0.694；Logistic回归分析发现，纵横比≥0.5、喉返神经旁淋巴结肿大为胸中上段食管癌病人发生颈部淋巴结转移的独立危险因素。结论：食管胸中上段癌病人颈部淋巴结短径、纵横比、内部回声、RI值、喉返神经旁淋巴结、胸部淋巴结肿大是预测颈部淋巴结转移的重要指标，其中纵横比≥0.5、喉返神经旁淋巴结肿大为胸中上段食管癌病人发生颈部淋巴结转移的独立危险因素。

关键词: 食管癌, 颈部淋巴结转移, 危险因素

Abstract: Objective：To explore the preoperative influencing factors for cervical lymph node metastasis in thoracic midupper esophageal carcinoma patients.Methods：A total of 64 esophageal carcinoma patients were divided into two groups，namely the metastasis group（20 cases）and nonlymph node metastasis group（44 cases）.The preoperative clinical data of the two groups were compared and analyzed the independent risk factors of cervical lymph node metastasis.Results：In the preoperative clinical data of patients with midupper esophageal carcinoma，the results of ultrasound examination included short diameter，aspect ratio，internal echo，RI value were closely related to the occurrence of cervical lymph node metastasis，and were statistically significant（all P<0.05）.Thoracic lymphatic enlargement，thoracic lymphatic enlargement along recurrent laryngeal nerve have significantly difference between the two groups（all P<0.05）.ROC curve analysis demonstrated important significance of short diameter and RI value in predicting cervical lymph node metastasis，with the area under ROC curve being 0.823，0.694，respectively.Logistic regression analysis showed that aspect ratio，thoracic lymphatic enlargements along recurrent laryngeal nerve were independent risk factors for cervical lymph node metastasis in esophageal carcinoma patients.Conclusion：The short diameter，aspect ratio，internal echo，RI value，thoracic lymphatic enlargement and thoracic lymphatic enlargement along recurrent laryngeal nerve may be important indexes in predicting cervical lymph node metastasis in patients with thoracic midupper esophageal carcinoma，moreover，the lymph node aspect ratio，thoracic lymphatic enlargement along recurrent laryngeal nerve are the independent risk factors of cervical lymph node metastases in patients with esophageal carcinoma.

Key words: esophageal carcinoma, cervical lymph node metastasis, risk factor

陈沛锐, 卿秋杉, 车国卫等. 术前胸中上段食管癌颈部淋巴结转移相关因素分析[J]. 临床外科杂志, 2019, 27(7): 566-569.

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