左锁骨上淋巴结的解剖及癌转移的病理分析

Anatomy of left supraclavicular lymph nodes and pathological analysis of carcinomatous metastasis

目的:观察左锁骨上淋巴结的形态、位置,探讨左锁骨上淋巴结肿瘤转移的机理。方法:对50具正常成尸标本的左锁骨上淋巴结进行了观察和测量,并对23例发生癌转移的左锁骨上淋巴结进行病理分析。结果:左锁骨上淋巴结分为内、外两部分,内侧部分位于左锁骨上三角内,外侧部分位于肩胛舌骨肌下腹与斜方肌前缘之间;左锁骨上淋巴结数目平均为(3.88±1.36)个。23例发生癌转移的左锁骨上淋巴结中,1例仅在输入淋巴管内查见癌细胞,1例仅在被膜下窦内查见癌细胞,4例在被膜下窦和小梁周窦内查见癌细胞,8例输入淋巴管、被膜下窦和小梁周窦内均含有癌细胞,9例输入淋巴管、被膜下窦、小梁周窦、输出淋巴管内含有癌细胞。结论:左锁骨上淋巴结以卵圆形为多(67%),主要位于锁骨上三角内(58.20%)。癌细胞经输入淋巴管转移至左锁骨上淋巴结。

Objective：To observe the shape and position of left supraclavicular lymph nodes, and discuss the mechanism of tumor metastasis. Methods：To observe and measure left supraclavicular lymph nodes in 50 adult specimens from Department of Human Anatomy, Weifang Medical University. We also made pathological analysis on left supraelavieular lymph nodes in 23 samples with metastatic carcinoma. Results ： Left supraelavicular lymph nodes were divided into medial and lateral parts. The medial part was situated in supraelavieular triangle;and the lateral part located between the lowermost belly of omohyoid muscle and the anterior border of trapezius. The average number of lymph nodes was 3.88 ± 1.36. Among 23 cases with left supraelavieular lymph nodes invaded, cancer cells could be seen in afferent lymphatic vessels and subeapsular sinus in 1 case respectively, in subcapsular sinus and eireum-trabeeula sinus in 4cases, in afferent lymphatic vessels, subcapsular sinus and eircum-trabecula sinus in 8 cases, in afferent lymphatic vessels, subeapsular sinus, eircum-trabecula sinus and efferent lymphatic vessels in 9 cases. Conclusions： Left supraclavicular lymph nodes were mainly oval in shape （67%） , and mostly lied in the supraclavicular triangle （58.20%）. Cancer cells were transferred to left supraelavieular lymph nodes by afferent lymphatic vessels.