摘要
目的 研究肺癌淋巴结转移的规律，探讨各病理类型、分期、部位肺癌淋巴结转移的特点，为合理施行淋巴结廓清提供理论依据。方法 通过对1998年10月至2005年3月施行根治性肺癌切除的194例病人淋巴结转移情况进行回顾性研究。结果 在不同部位、不同病理类型的肺癌中淋巴结转移频度较高的是第10组36．6％（71／194例）、第11组22．7％（44／194例）和第7组14．4％（28／194例）。不同病理类型肺癌中淋巴结转移情况;小细胞未分化癌76．9％（10／13例），腺癌59．3％（51／86例），鳞癌42．5％（37／87例）。T1期、T2期鳞癌和腺癌N0转移率相比差异有显著性。肺上叶癌较下叶癌更容易发生跳跃式纵隔淋巴结转移。肺下叶癌发生纵隔淋巴结转移的机率高于肺上叶。结论 各种肺癌根治术均应常规清除第10、11和7组淋巴结，T1期、T2期腺癌纵隔淋巴结清除的彻底性要高于鳞癌。肺上叶癌纵隔淋巴结清除要注意其跳跃式淋巴结转移的特点。肺下叶癌纵隔淋巴结清除要得到足够的重视。
Obijective To investigate the lymph node metastasis disciplin in lung carcinoma and approach the characteristics of lymph node metastasis in all kinds of patho - category, staging, location lung carcinoma,so we can provide the theoretical evidence for reasonable lymph mode clearance administrating. Methords we march the retrospective clinical analyais of lymph node metastasis in 194 patients who accept the radical lung carcinoma resection operation from 1998.10 to 2005.3 Results In different patho - category and location lung carcinoma, the higher frequency of metastatic lymph nodes are No.10 groop36.6% （71/194patlents）, No. llgroop22.7% （44/ 194patients）, No.7groop14.4% （28/194patients） .The sequence of lymph node metastasis frequence in all patho - categories is the small cell lung carcinoma 76.9% （ 10/13patients）, adenocarcinoma59.3% （51/86patients）, squalmouscell carcinoma 42.5% （37/87patlents） . there was a significant difference of N2 metastesis rates between squamous cell carcinoma and adenocarcinoma in T1 or T2 tumor. Lung cancers in upper lobes are more likely to spread to the mediastinum,Conclusion we must routinely dissect No. 10, Nol1 and No7 groop lymph nodes in various kinds of radicl lung cancer operation, and dissect the mediastinal lymph node more completely in T1 or T2 adenocarcino than aquamous cell carcinoma. We should pay attention to the saltational mediastinum metastasis of lobus superior pulmonis carcinoma.The lymph node dissection in lobus superior pulmonis carcinoma should be emphasized enough.
