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[目的]探讨胸段食管鳞癌胸腹部淋巴结转移的相关因素。[方法]回顾性分析612例胸段食管鳞癌患者的临床病理学资料与胸腹部淋巴结转移的关系,应用χ2检验进行单因素分析,应用Logistic回归分析进行多因素分析。[结果]淋巴结转移患者322例,转移率52.6%。清扫淋巴结16513枚,转移1128枚,转移度6.8%。胸部淋巴结转移245例,转移率40%。胸部淋巴结清扫总数8510枚,转移639枚,转移度7.5%。腹部淋巴结转移191例,转移率31.2%。腹部淋巴结清扫总数7765枚,转移458枚,转移度5.9%。Logistic回归分析提示,脉管瘤栓、腹部淋巴结转移、T分期、胸部淋巴结清扫数、分级、病变长度以及年龄是胸部淋巴结转移的独立危险因素,脉管瘤栓、贲门受侵、胸部淋巴结转移数、部位、腹部淋巴结清扫数以及病变长度是腹部淋巴结转移的独立危险因素。[结论]胸段食管鳞癌淋巴结清扫应该参照淋巴结转移的危险因素,合理地进行清扫。
[Objective] To investigate the related factors of thoracic and abdominal lymph node metastasis in thoracic esophageal squamous cell carcinoma. [Methods] A retrospective analysis of 612 cases of thoracic esophageal squamous cell carcinoma patients with clinicopathological data and the relationship between thoracoabdominal lymph node metastasis, χ2 test using univariate analysis, logistic regression analysis for multivariate analysis. [Results] There were 322 cases of lymph node metastasis with a rate of 52.6%. 16,513 lymph nodes were dissected, 1128 were transferred, and the degree of metastasis was 6.8%. 245 cases of thoracic lymph node metastasis, the transfer rate of 40%. The total number of chest lymph node dissection 8510, 639 transfer, transfer rate of 7.5%. Abdominal lymph node metastasis in 191 cases, the transfer rate was 31.2%. Totally 7765 abdomen lymph nodes were dissected, 458 were transferred and the degree of metastasis was 5.9%. Logistic regression analysis showed that the tumor thrombus, abdominal lymph node metastasis, T stage, number of thoracic lymph node dissection, grading, length of lesion and age were independent risk factors of thoracic lymph node metastasis. The incidence of thrombus, cardia invasion and thoracic lymph node metastasis , Location, number of lymph nodes dissection and lesion length were independent risk factors of lymph node metastasis of the abdomen. [Conclusion] The lymph node dissection of thoracic esophageal squamous cell carcinoma should be properly cleaned with reference to the risk factors of lymph node metastasis.