214例非小细胞肺癌淋巴结转移手术病理分析

METASTASIS OF NON-SMALL CELL LUNG CANCER IN LYMPH NODES—pathological analysis of 214 cases of operation

214例非小细胞肺癌行肺叶切除加同侧纵膈淋巴结清扫。手术和病理结果均显示 NSCL C淋巴结转移首先是叶支气管、肺门区 ,然后是纵膈各区 ,纵膈各区淋巴结转移与原发灶所在的部位有关 ;手术和病理 N分期相差甚远 ;直径 >2 0 mm的淋巴结病检癌转移率达 70 .9% ,而直径 <10 mm的淋巴结仍有 16 .3%病检证实为癌转移 ;术后 4月内临床发现上肺癌所致气管旁淋巴结转移的患者中有 83.4 %锁骨上淋巴结肿大。因此通过手术发现和病检结果的分析 ,有助于指导非手术 NSCLC放射治疗设计。

From April 1988 to May 1991,214 cases of NSCLC were operated by lobectomy, with the removal of the mediastinum lymph nodes at the disease site. Pathological examinations for lymph nodes were performed and results were analyzed. The results showed that metastasis to ipsilateal mediastinal lymph node related to site of primary tumor. The surgical N stages were different from the pathological N stages. Metastasis rates was 70.9% in lymph nodes with the diameter of >20mm ,but only 16.3% in <10mm . 4 months after surgery, 83.4% of supuaclavicular lymph node enlargement was found for patients with upper lung cancer accompanied with metastasis to upper-mediastinum lymph node. We think that surgical examination and pathological analysis are helpful for designing irradiation portals for non-operated NSCLC.