上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (3): 265-.doi: 10.3969/j.issn.1674-8115.2011.03.004

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第7版国际抗癌联盟食管鳞癌TNM分期解读

方文涛   

  1. 上海交通大学附属胸科医院胸外科 |食管疾病临床诊治中心, 上海 200030
  • 出版日期:2011-03-28 发布日期:2011-03-29
  • 作者简介:方文涛（1967—）, 男, 主任医师, 博士, 博士生导师；电子信箱: vwtfang@hotmail.com。

Clinical implications of 7th edition of UICC TNM staging system for esophageal squamous cancers

FANG Wen-tao   

  1. Clinical Center for Esophageal Diseases, Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai 200030, China
  • Online:2011-03-28 Published:2011-03-29

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摘要：

2009年第7版国际抗癌联盟（UICC）食管癌分期对T、N、M的划分标准都进行了较大的改动，新分期对我国食管外科的指导意义亟待临床验证。上海交通大学附属胸科医院选择性三野淋巴结清扫结果显示新分期能较好地反映食管癌的预后，其中肿瘤的浸润程度和淋巴结转移的范围是最为重要的独立预测因素。对于国内以局部中晚期胸段食管鳞癌为主的患者而言，通过提高术前临床分期的准确性以及有效的综合治疗是提高手术切除根治性和改善长期疗效的关键。

关键词: 食管癌, 手术, 淋巴结转移, 分期

Abstract:

The 7th edition of International Union Against Cancer (UICC) TNM staging system for esophageal cancers has been markedly revised in 2009 based on the former edition, and its clinical significance needs to be evaluated so as to better direct therapeutic management of the disease in China. Experience in selective three-field lymph node dissection from Shanghai Chest Hospital, Shanghai Jiaotong University indicates that the new staging system can effectively predict long-term prognosis for thoracic esophageal squamous cancers. Depth of tumor invasion and extent of lymph node involvement are the two most important prognostic factors. Squamous carcinomas located at thoracic esophagus predominate in Chinese patients. As the majority of Chinese patients tend to have locally advanced diseases, much effort is needed to increase the accuracy of preoperative staging, and to include effective induction therapies into a multidisciplinary setting so as to improve surgical outcomes.

Key words: esophageal cancer, surgery, lymph node metastasis, staging