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目的研究分析无淋巴结转移食管鳞癌术中清扫淋巴结数目对患者预后的影响。方法收集2009年10月-2012年12月收住焦作市第二人民医院的食管癌患者346例,住院期间均行食管癌根治术,术中进行淋巴结清扫,术后经病理证实为食管鳞癌,且均无淋巴结转移。搜集患者完整临床资料,记录术中清扫淋巴结数目并进行跟踪随访,分析清扫淋巴结数目与患者预后的关系。结果346例患者术中共清扫淋巴结9842枚,平均每例(24.6±7.2)枚。术后获得有效随访315例(91.0%),1年和3年生存率为80.3%(253/315)和66.3%(209/315)。术中淋巴结清扫数目0~14枚的患者术后1年和3年生存率显著低于清扫数目≥15枚的患者,差异有统计学意义(P<0.05)。结论对于无淋巴结转移食管鳞癌患者,术中应尽量清扫足够数目的淋巴结,消除复发或转移隐患,改善患者预后。
Objective To study the influence of the number of lymph nodes dissected in patients without lymph node metastasis on the prognosis of patients with esophageal squamous cell carcinoma without lymph node metastasis. Methods A total of 346 patients with esophageal cancer admitted to the Second People’s Hospital of Jiaozuo City from October 2009 to December 2012 were enrolled in this study. All patients underwent esophageal cancer radical mastectomy and lymph node dissection during operation. The patients were pathologically confirmed as esophageal squamous cell carcinoma , And no lymph node metastasis. The patients’ complete clinical data were collected, the number of lymph nodes dissected during operation and the follow-up were recorded, and the relationship between the number of lymph nodes dissected and the prognosis of patients was analyzed. Results A total of 9842 lymph nodes were dissected in 346 patients (average 24.6 ± 7.2). There were 315 cases (91.0%) with effective follow-up after operation. The 1-year and 3-year survival rates were 80.3% (253/315) and 66.3% (209/315) respectively. The 1-year and 3-year survival rates of patients with lymph node dissection between 0 and 14 were significantly lower than those with more than 15 patients (P <0.05). Conclusion For patients with esophageal squamous cell carcinoma without lymph node metastasis, a sufficient number of lymph nodes should be cleaned up during surgery to eliminate the recurrence or metastasis potential and improve the prognosis of patients.