Lymph node metastasis intensity of thoracic middle-lower segment esophageal squamous cell carcinoma

Objective To study the incidence of lymph node metastasis of thoracic middle-lower segment esophageal squamous cell carcinoma and find reasonable dissecting range of lymph nodes.Methods The clinical data of 325 patients receiving resection of thoracic middle-lower segment esophageal carcinoma were retrospectively studied.Results A total of 4 063 lymph nodes were dissected,in which lymph node metastasis was found in 643 lymph nodes(148 patients).The overall lymph node metastasis rate was 45.54%.The degree of lymph node metastasis was 15.83%.The lymph node metastasis had the features of extending vertically in both directions and leaping over.Lymph node metastasis was influenced by tumor differentiation and the depth of tumor invasion but not the length or the site of tumor.Conclusion Tumor differentiation and the depth of tumor invasion are the main factors influencing lymph node metastasis intensity.The cervical,thoracic and abdominal lymph node dissection should be done for the patients with earlier esophageal carcinoma of the middle thoracic segment.The thoracic and abdominal regional lymph node dissection is appropriate to esophageal carcinoma of the lower thoracic segment.