Risk factors for lymph node metastasis in esophageal cancer

doi:10.3877/cma.j.issn.1674-0785.2018.11.003

Abstract

Abstract:

Objective

To analyze the potential risk factors for lymph node metastasis in esophageal cancer.

Methods

A retrospective study was performed on 150 patients who underwent radical surgery for esophageal cancer at the First Affiliated Hospital of Zhengzhou University from December 2016 to December 2017. The patient′s medical records and postoperative pathological data were recorded. Age, sex, lesion location, and tumor differentiation were analyzed. Risk factors related to lymph node metastasis in esophageal carcinoma, such as tumor infiltration depth and tumor length (long tumor diameter), were identified using single factor χ² test and Logistic multivariate analysis.

Results

Among 150 patients with esophageal cancer, 60 had lymph node metastasis, and the positive rate was 40%. Univariate χ² test showed that lymph node metastasis was significantly associated with tumor differentiation and tumor length (χ²=16.928, P<0.001; χ²=12.06, P=0.002). Lymph node metastasis was not significantly associated with age, gender, lesion location, or depth of tumor invasion (P>0.05). Logistic multivariate analysis showed that tumor differentiation and tumor length were independent risk factors for lymph node metastasis.

Conclusion

Tumor differentiation and lesion length are independent risk factors for lymph node metastasis in esophageal cancer. Lymph node dissection and postoperative treatment should be comprehensively evaluated according to lymph node metastasis status.

Key words: Esophageal cancer, Lymph node metastasis, Risk factors

Kai Gao, Jia Shi, Chunyang Zhang, Lu Han, Yu Qi. Risk factors for lymph node metastasis in esophageal cancer[J]. Chinese Journal of Clinicians(Electronic Edition), 2018, 12(11): 605-608.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhlcyszz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0785.2018.11.003

https://zhlcyszz.cma-cmc.com.cn/EN/Y2018/V12/I11/605

Figures/Tables 2

References 17

1	Tachimori Y, Ozawa S, Numasaki H, et al. Comprehensive registry of esophageal cancer in Japan, 2010 [J]. Esophagus, 2017, 14(3):189-214.
2	李林峻，张诚，张敏, 等. 食管癌根治术后生存状态的5年随访研究[J]. 重庆医科大学学报, 2017, 42(10):1340-1344.
3	Jemal A, Siegel R, Xu J, et al. Cancer statistics, 2010 [J]. CA Cancer J Clin, 2010, 60(5):277-300.
4	赵海龙，薛继军，郑凤长, 等. 食管癌术后生存五年以上患者复发转移的相关因素分析[J]. 中国胸心血管外科临床杂志, 2016, 23(6):546-549.
5	Zhang D, Zheng Y, Wang Z, et al. Comparison of the 7th and proposed 8th editions of the AJCC/UICC TNM staging system for esophageal squamous cell carcinoma underwent radical surgery [J]. Eur J Surg Oncol, 2017, 43(10):1949-1955.
6	秦建军，李印. 日本食管协会(JES)第11版食管癌TNM分期简介[J]. 中国胸心血管外科临床杂志, 2017, 24(9):657-660.
7	段晓峰，尚晓滨，唐鹏, 等. T1期食管癌淋巴结转移的预后因素分析 [J]. 中华外科杂志, 2017, 55(9):690-695.
8	Rizk NP, Ishwaran H, Rice TW, et al. Optimum lymphadenectomy for esophageal cancer [J]. Ann Surg, 2010, 251(1):46-50.
9	吴彬，徐志飞，孙耀昌, 等. 食管癌的侵犯深度及分化程度与区域淋巴结转移的关系 [J]. 第二军医大学学报, 2000, 21(8):771-773.
10	Li H, Zhang Y, Cai H, et al. Pattern of lymph node metastases in patients with squamous cell carcinoma of the thoracic esophagus who underwent three-field lymphadenectomy [J]. Eur Surg Res, 2007, 39(1):1-6.
11	袁运长，喻风雷，尹邦良, 等. 胸段食管癌淋巴结转移156例临床分析[J]. 中国综合临床, 2005, 21(10):908-909.
12	王军，韩春，祝淑钗, 等. 胸段食管癌淋巴结转移规律及其影响因素[J]. 中国肿瘤临床, 2010, 37(2):90-93.
13	张合林，何明，孟宪利, 等. 1146例胸段食管癌淋巴结转移的相关因素[J]. 中国肿瘤临床, 2007, 34(11):650-652, 660.
14	代磊，任自学，张安庆, 等. 177例胸段食管癌淋巴结转移规律研究[J]. 中国胸心血管外科临床杂志, 2017, 24(2):122-126.
15	Akutsu Y, Matsubara H. Lymph node dissection for esophageal cancer [J]. Gen Thorac Cardiovasc Surg, 2013, 61(7):397-401.
16	张颖颖，王玉，张航, 等. 三野与二野淋巴结清扫术治疗食管癌疗效及安全性的系统评价与Meta分析[J]. 中国胸心血管外科临床杂志, 2016, 23(8):814-821.
17	van der Schaaf M, Johar A, Wijnhoven B, et al.Extent of lymph node removal during esophageal cancer surgery and survival [J]. J Natl Cancer Inst, 2015, 107(5). pii: djv043.

临床因素		有淋巴结转移	无淋巴结转移	χ²值	P值
年龄（岁）		?	?	0.361	0.548
?	<65	27	45	?	?
?	≥65	33	45	?	?
性别		?	?	0.000	1.000
?	男	42	63	?	?
?	女	18	27	?	?
病变部位		?	?	0.350	0.839
?	食管上段	8	15	?	?
?	食管中段	28	39	?	?
?	食管下段	24	36	?	?
肿瘤分化程度		?	?	16.928	<0.001
?	低分化	33	20	?	?
?	中高分化	27	70	?	?
肿瘤浸润深度		?	?	7.045	0.070
?	Tis	0	5	?	?
?	T1	6	23	?	?
?	T2	21	20	?	?
?	T3	23	33	?	?
?	T4	10	9	?	?
肿瘤长径		?	?	12.06	0.002
?	<3 cm	27	65	?	?
?	3~5 cm	21	13	?	?
?	>5 cm	12	12	?	?

临床因素		有淋巴结转移	无淋巴结转移	χ²值	P值
年龄（岁）		?	?	0.361	0.548
?	<65	27	45	?	?
?	≥65	33	45	?	?
性别		?	?	0.000	1.000
?	男	42	63	?	?
?	女	18	27	?	?
病变部位		?	?	0.350	0.839
?	食管上段	8	15	?	?
?	食管中段	28	39	?	?
?	食管下段	24	36	?	?
肿瘤分化程度		?	?	16.928	<0.001
?	低分化	33	20	?	?
?	中高分化	27	70	?	?
肿瘤浸润深度		?	?	7.045	0.070
?	Tis	0	5	?	?
?	T1	6	23	?	?
?	T2	21	20	?	?
?	T3	23	33	?	?
?	T4	10	9	?	?
肿瘤长径		?	?	12.06	0.002
?	<3 cm	27	65	?	?
?	3~5 cm	21	13	?	?
?	>5 cm	12	12	?	?

因素	β	SE	Wald值	P值	OR	95%CI
肿瘤分化程度	5.458	1.093	24.953	<0.001	2.252	2.594~83.765
肿瘤长径	3.227	1.734	23.465	<0.001	1.205	1.153~6.043
常量	3.318	3.225	7.171	0.006	2.379	1.095~18.206

因素	β	SE	Wald值	P值	OR	95%CI
肿瘤分化程度	5.458	1.093	24.953	<0.001	2.252	2.594~83.765
肿瘤长径	3.227	1.734	23.465	<0.001	1.205	1.153~6.043
常量	3.318	3.225	7.171	0.006	2.379	1.095~18.206

[1]	Huanyan Liu, Yang Hua, Lingyun Jia, Xinyu Zhao, Beibei Liu. Lumen structure and hemodynamic characteristics of occluded internal carotid artery [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 809-815.
[2]	Yanbo Ma, Yang Hua, Guimei Liu, Xiufeng Meng, Liping Cui. Risk factors for carotid atherosclerotic lesions in middle adults [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 822-826.
[3]	Guo Sun, Yingdong Xie, Chaoli Xu, Bin Yang. Clinical value of a nomogram based on ultrasonic and clinical features for predicting central and lateral cervical lymph node metastases of thyroid papillary carcinoma [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(07): 734-742.
[4]	Xu Tang, Bing Han, Wei Liu, Ruxing Chen. Analysis of risk factors for metachronous liver metastases after radical colorectal cancer surgery and construction of a predictive model [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 16-20.
[5]	Fangyuan Wu, Xia Sun, Changfeng Lin, Zhensheng Zhang. Risk factors of HBV-associated cirrhosis complicated with acute upper gastrointestinal bleeding [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 45-47.
[6]	Yutao Yuan, Jinlin Xing, Kefei Xie, Kai Yin. Correlation between CT findings and BRAF^V600E gene mutation and central lymph node metastasis in papillary thyroid carcinoma [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(06): 611-614.
[7]	Yonghuan Mao, Hanwen Tong, Ji Miao, Xingzhou Wang, Xiaofei Shen, Chunzhao Yu. Analysis of risk factors and prediction model of parastomal hernia [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(06): 682-687.
[8]	Chao Hou, Meichen Pan, Wenming Wu, Xingguang Huang, Xiang Li, Lingxue Cheng, Yuxuan Zhu, Wenbo Li. Risk factors of esophageal stricture after endoscopic submucosal dissection for early esophageal carcinoma and intraepithelial neoplasia [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(06): 383-387.
[9]	Qiujie Shan, Lizhu Sun, Yiquan Xu, Zhixia Wang, Yan Xu, Hao Ma, Tiantian Liu. Construction and application of radiation-induced lung injury risk model for middle-aged and elderly patients with esophageal cancer during intensity modulated radiotherapy [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(06): 388-393.
[10]	Wen Zhang, Mudan Song, Xueting Deng, Yun Zhang. Enhanced nutritional support assisted with octreotide in the treatment of esophageal and gastric variceal bleeding in patients with liver cirrhosis and risk factors for rebleeding [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(06): 456-460.
[11]	Menggui Lu, Bin Huang, Qiulin Li, Yuanmei He. Risk factors for multiple organ dysfunction syndrome in patients with bee sting injury [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(9): 1010-1015.
[12]	Da Li, Daya Zhang, Runxiang Chen, Xiaodong Zhang, Shimei Huang, Chen Chen, fan Zeng, Shiju Chen, Feihu Bai. Epidemiological characteristics and risk factors of Helicobacter pylori infection in Dongfang city of Hainan province [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(08): 858-864.
[13]	Ke Meng, Yan Li, Jingshuang Yan, Bin Yan. Risk factors for prolonged gastric transit time in capsule endoscopy [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(06): 671-675.
[14]	Yanli Yang, Yu Chen, Ruochen Zhao, Wei Du, Haijuan Ma, Ke Xu, Liyun Zhang. Bloodstream infection in patients with systemic lupus erythematosus: risk factors and bacteriological analysis [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(06): 694-699.
[15]	Peipei Sun, Erming Zhang, Yanwei Shi, Chunyan Zhao, Pingping Song, Shuo Zhang, Ke Zhang, Yujiao Zhou, Can Zhao, Wei Yan, Rongju Wu, Liping Song, Weian Guo, Shitou Ma, Xinhua An, Caoxin Bao, Pingchao Xiang. Prevalence and risk factors of chronic obstructive pulmonary disease in residents aged 40 years and above in Shijingshan district of Beijing [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(06): 711-719.

Please choose a citation manager

Content to export