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目的 :探讨食管癌的侵犯深度及细胞分化程度与区域淋巴结转移的关系。方法 :回顾性分析 1996年 5月至 1999年5月在我院行手术治疗的 470例食管癌患者临床及病理资料 ,比较肿瘤不同侵犯深度、细胞分化程度之间区域淋巴结转移情况的差异。 结果 :随着肿瘤侵犯深度的加深及细胞分化程度的降低 ,区域淋巴结的转移度呈显著上升趋势 (χ2 检验 ,P<0 .0 1)。一旦肿瘤侵犯超过深肌层 ,区域淋巴结的转移度显著增加 ,与侵及浅肌层相比 ,T2期肿瘤侵及深肌层者淋巴结转移度增加 10倍 ,T3期增加 17倍 ,T4期增加 2 3倍 ;与高分化食管癌相比 ,中分化癌淋巴结转移度增加 3倍 ,中低分化癌增加 4.5倍 ,低分化癌增加 6倍。结论 :食管癌患者肿瘤的侵犯深度及细胞分化程度是预计区域淋巴结转移状态的重要因素 ,在食管癌的临床分期、治疗方法的选择及预后判断方面起重要作用。
Objective: To investigate the relationship between the depth of invasion of esophageal carcinoma and the degree of cell differentiation and regional lymph node metastasis. METHODS: The clinical and pathological data of 470 patients with esophageal cancer who underwent surgical treatment in our hospital from May 1996 to May 1999 were retrospectively analyzed. The differences in regional lymph node metastases between different depths of tumor invasion and cell differentiation were compared. RESULTS: With the deepening of tumor invasion and the decrease of cell differentiation, regional lymph node metastasis showed a significant increase (χ2 test, P < 0.01). Once the tumor invades the deeper muscular layer, the regional lymph node metastasis increases significantly. Compared with the invasion of the superficial muscularis, the degree of lymph node metastasis in the T2 stage tumor invading the deep muscular layer is increased by 10 times, 17 times in the T3 stage, and increased in the T4 stage. 2 3 times; Compared with well-differentiated esophageal cancers, the lymph node metastasis of moderately differentiated cancers increased 3-fold, moderately-differentiated carcinomas increased 4.5-fold, and poorly-differentiated carcinomas increased 6-fold. Conclusion : The depth of tumor invasion and the degree of cell differentiation in esophageal cancer patients are important factors in predicting regional lymph node metastasis. It plays an important role in the clinical stage, selection of treatment methods and prognosis of esophageal cancer.