目的探討腹段食管癌及賁門癌淋巴結(jié)轉(zhuǎn)移特征的異同點。方法收集36例腹段食管癌及28例賁門癌患者術(shù)前CT資料,觀察記錄淋巴結(jié)大小、優(yōu)勢分布情況,并進(jìn)行統(tǒng)計學(xué)分析,了解有無差異。結(jié)果以淋巴結(jié)短徑≥10 mm為轉(zhuǎn)移標(biāo)準(zhǔn),腹段食管癌CT淋巴結(jié)檢出率為73.5%(144/196),賁門癌CT淋巴結(jié)檢出率為83.7%(170/203)。 腹段食管癌胸腔淋巴結(jié)轉(zhuǎn)移率: 7區(qū)11.1%(4/36 )、8區(qū)27.8%(10/36)、9區(qū)8.3%(3/36),腹腔轉(zhuǎn)移以No.7組 36.1%(13/36 )、No.1組19.4%(7/36)及No.2組11.1%(4/36)為主。賁門癌淋巴結(jié)轉(zhuǎn)移以第1站的No.1組17.9%(5/28)、No.2組28.6%(8/28)、No.3組39.3%(11/28)、No.4組25.0%(7/28)及第2站的No.7組35.7%(10/28)為主。 結(jié)論CT以短徑≥10 mm為淋巴結(jié)轉(zhuǎn)移判斷標(biāo)準(zhǔn)具有可行性,但存在一定假陽性率。腹段食管癌胸腔淋巴結(jié)轉(zhuǎn)移以7、8、9區(qū)為主,腹腔轉(zhuǎn)移以No.7組及No.1、No.2組為主。賁門癌淋巴結(jié)轉(zhuǎn)移以第1站的No.1~No.4組及第2站的No.7組為主。
引用本文: 漆銳,余建群,李學(xué)明,黃子星. 多層螺旋CT對腹段食管癌與賁門癌淋巴結(jié)轉(zhuǎn)移特征的評價. 中國普外基礎(chǔ)與臨床雜志, 2011, 18(5): 555-559. doi: 復(fù)制
1. | 陳峻青. 胃癌、食管癌、大腸癌有關(guān)淋巴結(jié)的分組及其代號 [J]. 實用外科雜志, 1987, 7(2): 100102. |
2. | 李媛, 楊志剛. 縱隔淋巴結(jié)病變的斷層影像表現(xiàn)特征及其解剖、病理學(xué)基礎(chǔ) [J]. 實用放射學(xué)雜志, 2007, 23(2): 252255. |
3. | Udagawa H, Akiyama H. Surgical treatment of esophageal cancer Tokyo experience of the threefield technique [J]. Dis Esophagus, 2001, 14(7): 110114. |
4. | 伊斯坎達(dá)爾, 張建慶, 王海峰, 等. 胸段食管癌淋巴結(jié)轉(zhuǎn)移率及轉(zhuǎn)移方向 [J]. 腫瘤防治研究, 2007, 34(2): 143145. |
5. | 劉寶善. 消化器官腫瘤 [M]. 北京: 人民衛(wèi)生出版社, 2004: 317. |
6. | 朱艷清, 饒靈寧, 韓文龍, 等. 胃癌患者胃周淋巴結(jié)大小與轉(zhuǎn)移及N分期的關(guān)系 [J].臨床軍醫(yī)雜志, 2008, 36(1): 5254. |
7. | Fukuya T, Honda H, Hayashi T, et al. Lymphnode metastasis: efficiency of detection with helical CT on patients with gastric cancer [J]. Radiology, 1995, 197(3): 705711. |
8. | Herbella FA, Del Grande JC, Colleoni R, et al. Anatomical analysis of the mediastinal lymph nodes of normal brazilian subjects according to the classification of the japanese society for diseases of the esophagus [J]. Surg Today, 2003, 33(8): 249253. |
9. | Lerut T, Nafteux P, Moons J, et al. Threefield lymphadenectomy for carcinoma of the esophagus and gastroesophageal junction in 174 R0 resection impacton staging diseasefree survival and outcome [J]. Ann Surg, 2004, 240(6): 962972. |
10. | 紀(jì)勇, 陳國強, 黃斌, 等. 胸段食管鱗癌淋巴結(jié)轉(zhuǎn)移規(guī)律及淋巴結(jié)清掃方式探討 [J]. 山東醫(yī)藥, 2010, 50(38): 1617. |
11. | Tachimori Y, Kato H, Watanabe H, et al. Difference between carcinoma of the lower esophagus and the cardia [J]. World J Surg, 1996, 20(4): 507511. |
12. | Ichikura T, Ogawa T, Kawabata T, et al. Is adenocarcinoma of the gastric cardia distinct entity independent of subcardial carcinoma [J]. World J Surg, 2003, 27(3): 334338. |
13. | Stein HJ, Feith M, Siewert JR. Cancer of the esophagogastric junction [J]. Surgical Oncology, 2000, 9(1): 3541. |
14. | de Manzoni G, Morgagni P, Roviello F, et al. Nodal abdominal spread in adenocarcinoma of the cardia. Result of a multicenter prospective study [J]. Gastric Cancer, 1998, 1(2): 146151. |
15. | 李鑒, 張汝剛, 張大為, 等. 賁門腺癌淋巴結(jié)轉(zhuǎn)移及分站的COX模型多因素分析(附736例報告) [J]. 中華腫瘤雜志, 1998, 20(1): 5456. |
16. | 崔燕海, 張曉鵬, 唐磊,等. 賁門癌CT檢出淋巴結(jié)分布的影像學(xué)特點 [J]. 中國醫(yī)學(xué)影像技術(shù), 2007, 23(4): 553557. |
17. | 朱正綱, 草野滿夫. 胃癌根治術(shù)中清掃腹主動脈旁淋巴結(jié)的研究現(xiàn)狀及其臨床意義 [J].中國腫瘤臨床, 1997, 24(5): 380387. |
18. | de Manzoni G, Pedrazzani C, Di Leo A, et al. Metastases to the paraaortic lymph nodes in adenocarcinoma of the cardia [J]. Eur J Surg, 2001, 167(6): 413418. |
19. | 所劍. 胃癌的淋巴結(jié)清掃及意義 [J]. 中國普外基礎(chǔ)與臨床雜志, 2010, 17(1): 57. |
- 1. 陳峻青. 胃癌、食管癌、大腸癌有關(guān)淋巴結(jié)的分組及其代號 [J]. 實用外科雜志, 1987, 7(2): 100102.
- 2. 李媛, 楊志剛. 縱隔淋巴結(jié)病變的斷層影像表現(xiàn)特征及其解剖、病理學(xué)基礎(chǔ) [J]. 實用放射學(xué)雜志, 2007, 23(2): 252255.
- 3. Udagawa H, Akiyama H. Surgical treatment of esophageal cancer Tokyo experience of the threefield technique [J]. Dis Esophagus, 2001, 14(7): 110114.
- 4. 伊斯坎達(dá)爾, 張建慶, 王海峰, 等. 胸段食管癌淋巴結(jié)轉(zhuǎn)移率及轉(zhuǎn)移方向 [J]. 腫瘤防治研究, 2007, 34(2): 143145.
- 5. 劉寶善. 消化器官腫瘤 [M]. 北京: 人民衛(wèi)生出版社, 2004: 317.
- 6. 朱艷清, 饒靈寧, 韓文龍, 等. 胃癌患者胃周淋巴結(jié)大小與轉(zhuǎn)移及N分期的關(guān)系 [J].臨床軍醫(yī)雜志, 2008, 36(1): 5254.
- 7. Fukuya T, Honda H, Hayashi T, et al. Lymphnode metastasis: efficiency of detection with helical CT on patients with gastric cancer [J]. Radiology, 1995, 197(3): 705711.
- 8. Herbella FA, Del Grande JC, Colleoni R, et al. Anatomical analysis of the mediastinal lymph nodes of normal brazilian subjects according to the classification of the japanese society for diseases of the esophagus [J]. Surg Today, 2003, 33(8): 249253.
- 9. Lerut T, Nafteux P, Moons J, et al. Threefield lymphadenectomy for carcinoma of the esophagus and gastroesophageal junction in 174 R0 resection impacton staging diseasefree survival and outcome [J]. Ann Surg, 2004, 240(6): 962972.
- 10. 紀(jì)勇, 陳國強, 黃斌, 等. 胸段食管鱗癌淋巴結(jié)轉(zhuǎn)移規(guī)律及淋巴結(jié)清掃方式探討 [J]. 山東醫(yī)藥, 2010, 50(38): 1617.
- 11. Tachimori Y, Kato H, Watanabe H, et al. Difference between carcinoma of the lower esophagus and the cardia [J]. World J Surg, 1996, 20(4): 507511.
- 12. Ichikura T, Ogawa T, Kawabata T, et al. Is adenocarcinoma of the gastric cardia distinct entity independent of subcardial carcinoma [J]. World J Surg, 2003, 27(3): 334338.
- 13. Stein HJ, Feith M, Siewert JR. Cancer of the esophagogastric junction [J]. Surgical Oncology, 2000, 9(1): 3541.
- 14. de Manzoni G, Morgagni P, Roviello F, et al. Nodal abdominal spread in adenocarcinoma of the cardia. Result of a multicenter prospective study [J]. Gastric Cancer, 1998, 1(2): 146151.
- 15. 李鑒, 張汝剛, 張大為, 等. 賁門腺癌淋巴結(jié)轉(zhuǎn)移及分站的COX模型多因素分析(附736例報告) [J]. 中華腫瘤雜志, 1998, 20(1): 5456.
- 16. 崔燕海, 張曉鵬, 唐磊,等. 賁門癌CT檢出淋巴結(jié)分布的影像學(xué)特點 [J]. 中國醫(yī)學(xué)影像技術(shù), 2007, 23(4): 553557.
- 17. 朱正綱, 草野滿夫. 胃癌根治術(shù)中清掃腹主動脈旁淋巴結(jié)的研究現(xiàn)狀及其臨床意義 [J].中國腫瘤臨床, 1997, 24(5): 380387.
- 18. de Manzoni G, Pedrazzani C, Di Leo A, et al. Metastases to the paraaortic lymph nodes in adenocarcinoma of the cardia [J]. Eur J Surg, 2001, 167(6): 413418.
- 19. 所劍. 胃癌的淋巴結(jié)清掃及意義 [J]. 中國普外基礎(chǔ)與臨床雜志, 2010, 17(1): 57.