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目的探索胸段食管癌术后复发、淋巴结转移部位的规律,旨在为术后预防性照射的靶区设计提供依据。方法选择食管癌术后复发患者182例,回顾性分析其原发肿瘤部位、术后分期与食管癌术后复发、淋巴结转移部位的关系。结果 182例食管癌术后复发患者最常见的复发部位为1区/2区淋巴结(112例)、锁骨上淋巴结(45例);胸上段、胸中段、胸下段食管癌1区/2区淋巴结转移率分别为64.3%、61.4%、60.0%,锁骨上区淋巴结转移率分别为28.6%、23.6%、25.0%,各段1区/2区、锁骨上区淋巴结转移率比较P均>0.05。Ⅱa、Ⅱb、Ⅲ期食管癌术后1区/2区淋巴结转移率分别为11.3%、28.6%、49.1%,锁骨上区淋巴结转移率分别为9.4%、26.8%、45.3%,各期1区/2区、锁骨上区淋巴结转移率比较P均<0.05。结论 1区/2区淋巴结及锁骨上区是食管癌术后常见复发、淋巴结转移部位,应将其作为重要的术后预防性照射靶区。
Objective To explore the regularity of recurrence and lymph node metastasis of thoracic esophageal cancer, aiming to provide the basis for the target design of postoperative prophylactic irradiation. Methods A total of 182 patients with postoperative recurrence of esophageal cancer were retrospectively analyzed. The relationship between their primary tumor site, postoperative staging and postoperative recurrence and lymph node metastasis of esophageal cancer was retrospectively analyzed. Results The most common recurrence sites of the 182 patients with esophageal cancer recurrence were the lymph nodes in Zone 1 / Zone 2 (112 cases) and supraclavicular lymph nodes (45 cases). The lymph nodes in the upper thoracic, middle thoracic, and thoracic esophagus in Zone 1 / The metastatic rates were 64.3%, 61.4% and 60.0% respectively. The rates of lymph node metastasis in supraclavicular area were 28.6%, 23.6% and 25.0% respectively. The lymph node metastasis rates in stage IIa, IIb and III esophagectomy were 11.3%, 28.6% and 49.1% respectively. The rates of lymph node metastasis in the supraclavicular area were 9.4%, 26.8% and 45.3% / 2 area, supraclavicular lymph node metastasis rate P <0.05. Conclusion Lymph nodes and supraclavicular areas in zone 1 / zone 2 are common postoperative recurrence and lymph node metastasis of esophageal cancer, which should be regarded as an important target for postoperative prophylactic irradiation.