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目的:了解食管癌和贲门癌腹腔动脉干区淋巴结的转移特点及对预后的影响,探讨合理的腹腔区域淋巴结清扫范围。方法:对836例手术切除食管癌和贲门癌患者的临床资料进行分析。结果:腹腔淋巴结转移率60.3%,淋巴结转移度16.8%。肝总动脉旁、腹腔动脉旁、肝十二指肠韧带内淋巴结转移度分别为10.4%、10.1%和9.8%。患者术后3年腹腔淋巴结复发转移率为6.1%。患者术后3年生存率为55.7%,其中有腹腔淋巴结转移的患者术后3年生存率为44.6%,低于无腹腔淋巴结转移的患者(72.4%),P<0.05。结论:腹腔淋巴结转移是影响食管癌和贲门癌切除患者预后的一个主要因素,对腹腔动脉干区淋巴结的广泛清扫可以降低术后的局部复发率。
OBJECTIVE: To investigate the metastatic characteristics of lymph nodes in celiac trunk of esophageal and gastric cardia carcinoma and their prognosis, and explore the reasonable range of lymph node dissection in peritoneal cavity. Methods: The clinical data of 836 patients with esophageal and cardiac cancer were analyzed. Results: The rate of celiac lymph node metastasis was 60.3% and the degree of lymph node metastasis was 16.8%. Adjacent to the common hepatic artery, celiac artery, and hepatoduodenal ligament, the degree of lymph node metastasis was 10.4%, 10.1% and 9.8% respectively. Three years after surgery, the rate of recurrence and metastasis of abdominal lymph nodes was 6.1%. The 3-year survival rate was 55.7%. The 3-year survival rate of patients with celiac lymph node metastasis was 44.6%, which was lower than that of patients without celiac lymph node metastasis (72.4%) (P <0.05). CONCLUSION: Celiac lymph node metastasis is a major factor influencing the prognosis of esophageal and gastric cardia resection patients. Extensive dissection of lymph nodes in celiac artery can reduce the local recurrence rate.