›› 2012, Vol. 24 ›› Issue (1): 64-67.doi: 10.3969/j.issn.1004-616x.2012.01.015

• 肿瘤防治 • 上一篇    下一篇

阴性淋巴结数目对胸段食管癌患者预后的影响

杜泽森，吴智勇，郑春鹏，李卓毅，傅俊惠   

  1. 汕头市中心医院，中山大学附属汕头医院肿瘤外科，广东 汕头 515031
  • 收稿日期:2011-09-19 修回日期:2011-12-10 出版日期:2012-01-30 发布日期:2012-01-30
  • 通讯作者: 傅俊惠

Prognostic significance of the number of negative lymph node on the survival of patients with thoracic esophageal cancer

DU Ze-sen，WU Zhi-yong，ZHENG Chun-peng，LI Zhuo-yi，FU Jun-hui   

  1. Department of Oncology Surgery, Shantou Central Hospital, Shantou 515031, Guangdon , China
  • Received:2011-09-19 Revised:2011-12-10 Online:2012-01-30 Published:2012-01-30
  • Contact: FU Jun-hui

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摘要： 目的： 探讨胸段食管癌患者标准淋巴结清扫术中阴性淋巴结数目对患者预后的影响。方法：回顾性分析2000~2006年，汕头市中心医院239例食管癌患者的性别、年龄、肿瘤定位、浸润深度、病理组织分化程度、类型以及阴、阳性淋巴结数目，通过Kaplan-Meier曲线和Cox多因素回归模型，评估上述临床病理参数等与患者生存期之间的相关性。结果：全组患者平均5年生存率44.1%。单因素分析结果显示，阳性淋巴结数目及阴性淋巴结数目对患者5年生存率有显著影响 (P<0.05)。阴性淋巴结数目≥4的患者，5年生存率 (49.1%)明显高于阴性淋巴结数目＜4的患者 (31.5%) (χ2=6.042，P=0.014)。Cox多因素回归分析显示，阳性淋巴结数目 (P=0.000， HR=1.370，95%CI =1.204~1.559)及阴性淋巴结数目 (P=0.046，HR=0.955，95%CI=0.913~0.999)均可作为影响患者预后的独立影响因素 (P<0.05)。结论：阴性淋巴结数目是胸段食管癌患者预后的独立影响因素，在今后的食管癌分期标准中可用于改进淋巴结分期。

关键词: 食管癌, 阴性淋巴结数目, 肿瘤转移, 预后

Abstract: OBJECTIVE: To explore the prognostic significance of the number of negative lymph node on survival rates in patients with thoracic esophageal cancer. METHODS：Clinicopathological and survival data were collected retrospectively in 239 patients with thoracic esophageal cancer in the Shantou Central Hospital between 2000 and 2006. Kaplan-Meier curves and the Cox regression analysis were used to evaluate the association between survival and each clinicopathological factor. RESULTS：The 5-year survival rate was 44.1% for the entire cohort. Univariate analysis indicated that both the positive and negative lymph node numbers were significant prognostic factors. Patients with 4 or more negative nodes had a better 5-year survival rate than those with fewer than 4 negative nodes (49.1% vs. 32.5%， respectively，χ2 = 6.042，P = 0.014). Based on multivariate regression analysis，positive and negative lymph node numbers were independent factors. CONCLUSION：The number of negative lymph nodes has significant prognostic impact on the survival rate of patients with thoracic esophageal cancer and could be integrated into the TNM staging consideration for esophageal cancer.

Key words: esophageal cancer, negative lymph node number, metastases, prognosis

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