摘要
目的分析胸段食管癌二野淋巴结清扫术后下颈部淋巴结转移规律，为术后放疗靶区勾画提供参考。方法搜集本院2004-2009年收治的126例胸段食管癌术后区域淋巴结转移患者的临床资料，参照Som等颈部影像学分区将下颈部分为Ⅰ区（上纵隔淋巴结）、Ⅱ区（脏器淋巴结）、巩区（颈内静脉内淋巴结）、Ⅲh区（颈内静脉外淋巴结）、Ⅳ区（锁骨上淋巴结）、V区（颈后三角淋巴结），并分析各区淋巴结转移情况。组间比较采用χ^2。检验，Logistic回归分析各区间淋巴结转移关系。结果全组126例区域淋巴结转移患者下颈部淋巴结转移占68．3％（86例），Ⅰ、Ⅱ、甄区淋巴结转移之和占下颈部淋巴结转移的95％（82例），其中Ⅰ、Ⅱ区占85％（73例）。右颈部淋巴结转移多于左颈部（53．2％：30．2％，χ^2=13．73，P=0．000），右侧Ⅰ、Ⅱ、风区淋巴结转移比例均高于左侧（43．7％：15．1％、17．5％：7．1％、17．5％：5．6％，χ^2=24．79、6．22、8．77，P=0．000、0．013、0．003）。结论胸段食管癌下颈部淋巴结转移主要集中于喉返神经旁（I、Ⅱ区）与颈内静脉内（皿区）淋巴结。
Objective To investigate the metastatic characteristics of cervical lymph node in thoracic esophageal cancer of two-field lymph node dissection after radical surgery and to provide evidence for postoperative radiotherapy. Methods Local-regional lymph node metastasis after surgery of 126 cases with esophageal squamous cell carcinoma from 2004 to 2009 were reviewed. Boundaries of cervical lymph node were according to Som, s imaging-based nodal classification system. Enumeration data were compared by X2 test , and the risk factors of lymph node metastasis were analyzed with Logistic regressive model . Results Lymph node metastasis rate of cervical region was up to 68.3% in all the cases with local-regional lymph node metastasis （86/126）, and lymph node metastasis rate in level I was higher than those in the other levels （43.7% , 55/126）. There was obvious difference in lymph node metastasis rate between the right and the left cervical region （53.2% vs 30.2% ,X2= 13.73 ,P =0. 000）. Moreover, the results also shown that lymph node metastasis rate was notably increased in levelⅠ ,Ⅱ and Ilia of the right compared with those of the left, showing statistical significance （43.7% ： 15.1%, 17.5% ： 7.1%, 17. 5% ： 5.6%, X2 = 24. 79, 6. 22,8.77 ,P = 0. 000,0. 013,0. 003 ）. The sum of lymph node metastasis rate was 95% （82/86） in para- recurrent nerve and medial jugular vein, and 85% （73/86） in para-recurrent nerve. In addition, multivariate analysis showed that lymph node metastasis in level Ⅰ was high risk factor for lymph node metastasis of level Ⅱ Conclusions Lymph node metastasis of cervical region mainly focused on para- recurrent nerve and medial jugular vein.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2012年第2期126-129,共4页
Chinese Journal of Radiation Oncology
基金
教育部留学归国人员启动基金（教外司留[2008]101号）
河北省普通高校强势特色学科（冀教高[2005]52号）
关键词
食管肿瘤/外科学
肿瘤转移
颈部淋巴结
放疗靶区
Esophageal neoplasms/surgery
Neoplasms metastasis, neck lymph node
Radiotherapy target volume
