男性164例锁骨上淋巴结转移瘤的病理学特点

Pathological characteristics of superaclavicular lymph nodes metastatic tumors in male: An analysis of 164 cases

目的分析男性锁骨上淋巴结转移瘤的某些病理学特点,为推测男性锁骨上淋巴结来源未明转移瘤（MUO）的可能原发部位提供参考性诊断思路。方法对近20年（1980-1999年）收验的164例男性锁骨上淋巴结转移瘤患者的年龄、转移瘤的组织学类型和原发部位进行分析,并对其中已知原发瘤部位（MKO）的131例患者年龄、受累及淋巴结侧位、转移瘤基本组织学类型等与原发瘤部位进行相关性分析。结果①33/164（20.12%）例未知原发部位。②MKO组与MUO组患者的年龄参数总体上相同或趋同。③MKO组和MUO组转移瘤皆半数以上为腺癌,居首位,腺癌与鳞癌之比分别为1∶0.47和1∶0.52。④原发瘤部位共计14处,皆来自远隔部位,分布于胸腔、腹腔和盆腔（计占96.1%）。⑤肺居原发瘤部位之首,且右侧者（77.09%）显著多于左侧（47.06%）（P〈0.01）;其次为胃,左侧者（28.74%）显著多于右侧（11.63%）（P〈0.05）,而后依序为食管、肝、鼻咽、胰腺、消化道（具体部位未明）、喉、眼睑、胆管、大肠、膀胱、前列腺和睾丸。结论对MUO和MKO组男性锁骨上淋巴结转移瘤的比较分析,显示了两组一些基本参数具有较好的（如年龄、组织学类型）或一定的（如侧位比率）可比性,提示有关男性锁骨上淋巴结MKO组原发瘤部位的资料对于推测该处淋巴结MUO组患者的转移瘤原发部位具有一定的参考意义。

Purpose To investigate the pathologic characteristics of 164 metastatic tumors in superaclavicular lymph nodess in male to provide diagnostic clues for speculating primary sites of metastatic tumors in superaclvicular lymph nodes in metastasis of unknown origin （MUO）. Methods The ages, basic histological patterns of 164 male patients with the metastatic tumors in superaclvicular lymph nodes in the last 20 years, and their correlation with the primary sites were analyzed in 131 patients with MKO. Results （ 1 ） 20. 12% cases were from MUO. （2） The age of metastasis with known origin （MKO） patients was identical or similar to that of MUO in general. （3） The metastatic tumors in MKO and MUO were mainly adenocarcinoma, and the ratio of adenocarcinoma and squmous cell. carcinoma was 1 ： 0. 47 and 1 ： 0. 52, respectively. （4） The numbers of primary tumor sites were 14. They were all derived from distant regions, which were organs mainly in the thorax, abdominal and the pelvic cavity （96. 1% ）. （5） The most common site of pri- mary tumor was the lung and the rate of the right side （77.09%） was higher than that of the left side （47.06%） remarkably. The second common site was stomach and the rate in the left side （28. 74% ） was higher than that in the right side （ 11.63% ）. The following orders were esophagus, liver, nasopharynx, pancreas, alimentary tract, larynx, eyelid, bile duct, large intestine, bladder, prostate and testicle in turn. Conclusion Analyses of 33 cases of superaclavicular lymph nodes metastasis with MUO and 131 with MKO in male reveal the data from MKO cases have better reference values for conferring the origin of primary tumor in MUO cases.