Para-recurrent lymph node metastasis was a significant predictor for cervical lymph nodes metastasis in thoracic esophageal carcinoma
LI Cheng-lin*,WANG Ya-di,HAN Chun, CHENG Yun-jie,CHI Zi-feng,SUN Guo-gui,ZHANG Fu-li,LIU Qing
*Department of Radiotherapy, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China Corresponding author:WANG Ya-di, Department of Radiotherapy, Military General Hospital of Beijing, Beijing 100700, China;Email:wangyadi@hotmail.com
Abstract:Objective To evaluate correlation factors of cervical lymph nodes metastasis in thoracic esophageal carcinoma. Methods Local-regional metastasis of lymph node for 126 cases with esophageal squamous cell cancer after surgery from 2004 to 2009 were reviewed. Risk factors of cervical lymph nodes metastasis were examined by multiple Logistic regression analysis. Results In 126 cases, supraclavicular lymph node metastasis rate was 43.7%(55/126). By logistic regression, none of the primary site, T stage, N stage, histological grade, lymph node metastasis rate, lymph node metastasis degree and number of lymph nodes metastatic field was not the high risk of cervical lymph nodes metastasis. In addition, multivariate analysis found that lymph node metastasis in mediastinum region 1 was high risk factor for lymph node metastasis of region I (χ2=12.14,9.27,P=0.000,0.002),lymph node metastasis in region Ⅲ and region 2 were high risk factors for lymph node metastasis of region Ⅱa(χ2=14.56,8.27,8.02,3.93,P=0.000,0.004,0.005,0.047). Conclusion Mediastinal para-recurrent nerve lymph node metastasis is a significant predictor for cervical lymph nodes metastasis.
LI Cheng-lin*,WANG Ya-di,HAN Chun et al. Para-recurrent lymph node metastasis was a significant predictor for cervical lymph nodes metastasis in thoracic esophageal carcinoma[J]. Chinese Journal of Radiation Oncology, 2012, 21(4): 340-342.
[1] 薛恒川,吴昌荣,张振斌,等.胸段食管癌胸腹二区淋巴结清扫及转移规律.癌症,2007,26:1020-1024. [2] 安丰山,黄金球,陈少湖.217例胸段食管癌淋巴结转移及其对预后影响的分析.癌症,2003,22:974-977. [3] 柳硕岩,佘志廉,朱坤寿.472例胸段食管癌行颈、胸、腹三野淋巴结清扫术的临床研究.福建医药杂志,2005,27:38-40. [4] 陈俊强,潘建基,陈明强,等.胸段食管癌淋巴结转移规律与放疗意义探讨.中华放射肿瘤学杂志,2007,16:330-333. [5] 李鹤成,张亚伟,相加庆.胸段食管癌淋巴结转移规律及其对淋巴结清扫方式的影响.中华胸心血管外科杂志,2007,23:252-254. [6] 肖泽芬,杨宗贻,梁军,等.食管癌根治术后预防性放疗的临床价值.中华肿瘤杂志,2002,24:608-611. [7] 陈俊强,陈明强,李云英,等.胸段食管癌三野根治术后放疗靶区的临床研究.中华放射医学与防护杂志,2006,26:374-377. [8] Som PM, Curtin HD, Mancuso AA. Imaging based nodal classification fur evaluation of neck metastatic adenopathy. Am J Radiol,2000,174:837-844. [9] 毛友生,赫捷,程贵余.我国食管癌外科的现状与外来对策.中华肿瘤杂志,2010,32:401-404. [10] Malassagne B, Tiret E, Duprez D, et al. Prognostic value of thoracic recurrent nerve nodal involvement in esophageal squamous cellcarcinoma. J Am Coll Surg,1997,185:244-249. [11] Tabira Y, Yasunaga M, Tanka M, et al. Significance of three-field lymphadenectomy for carcinoma of the thoracic esophagus based ondepth of tumor infiltration, lymph nodal involvement and survival rate. J Cardiovasc Surg (Torino),1999,40:737-740. [12] Shiozaki H, Yano M, Tsujinaka T, et al. Lymph node metastasis along the recurrent nerve chain is an indication for cervical lymph nodedissection in thoracic esophageal cancer. Dis Esophagus,2001,14:191-196. [13] 方文涛,陈文虎.食管癌淋巴结清扫术的沿革.中国癌症杂志,2008,5:345-349. [14] Tabira Y, Yasunaga M, Tanaka M, et al. Recurrent nervenodal involvement is associated with cervcal nodal metastasis in thoracic esophageal carcinoma. J Am Coll Surg,2000,191:232-237. [15] Yoshioka S, Fujiwara Y, Sugita Y, et al. Real-time rapid reverse transcriptase-polymerase chain reaction for intraoperative diagnosis of lymph node micrometastasis:clinical application for cervical lymph node dissection in esophageal cancers. Surgery,2002,132:34-40. [16] 张亚伟,胡鸿,缪珑升,等.胸中段食管癌淋巴结二野清扫术和三野清扫术的比较.中国癌症杂志,2008,18:537-541. [17] Ueda Y, Shiozaki A, Itoi H, et al.Intraoperative pathological investigation of recurrent nerve nodal metastasis can guide the decision whether to perform cervical lymph node dissection in thoracic esophageal cancer. Oncol Rep,2006,16:1061-1066.