211267 A clinical analysis of risk factor with lymph node metastatic recurrence in patients with N0 esophageal cancer after Ivor-Lewis Esophagectomy

/Sun Zhigang(孫志鋼，Dept Thorac Surg，Provin Hosp Affil Shandong Univ，Jinan 250021)…∥Chin J Thorac Cardiovasc Surg.-2011，27(2).-108 ～111

ObjectiveTo investigate the risk factors with lymph node metastatic recurrence in patients with N0 esophageal cancer after Ivor-Lewis Esophagectomy.MethodsThe subjects were 82 patients with pN0 esophageal cancer who underwent Ivor-Lewis esophagectomy from January 2001 to January 2005.By using RT-PCR，VEGFC mRNA was detected in tumor issues，and Mucin l(MUC1)mRNA was detected in lymph nodes.The Kaplan-Meier method was used to calculate the survival rate and lymph nodal metastatic rate.Log-rank test was performed to compare the recurrence rate，and Cox regression multivariate analysis was performed to determine independent prognostic factors.ResultsVEGF-C mRNA was identified in 42 patients(51.22%)，and MUC1 mRNA was identified in 23 patients(28.05%)from at least 1 lymph node station.The diagnosis of lymph node micrometastasis(LNMM)was based on the detection of MUC1 mRNA.The first recurrence exhibiting lymph node metastasis was recognized in 37 patients(45.1%)at the first 3 years after operation and this was significantly associated with T status(P ＜ 0.05).Lymph node metastatic rate for patients with VEGF-C mRNA expression in tumor issues was significantly higher than that for patients without VEGF-C mRNA expression(P ＜0.01).And lymph node metastatic rate for patients with LNMM was significantly higher than that for patients without LNMM(P ＜0.01).

The results of multivariate analysis confirmed that T status，VEGF-C mRNA expression in tumor issues and LNMM were independent relevant factors.ConclusionStatus，VEGF-C mRNA expression in tumor issues and LNMM in patients with N0 esophageal cancer were independent risk factors for 3-year lymph node metastatic recurrence after Ivor-Lewis Esophagectomy.10 refs，4 figs，2 tabs.