非小细胞肺癌淋巴结转移规律的研究

Metastatic patterns of lymph node in non-small cell lung cancer

目的:探讨非小细胞肺癌(NSCLC)的肿瘤大小、外侵程度、病理类型、肿瘤部位等与淋巴结转移的关系。方法:对145例NSCLC行肺癌切除和纵隔淋巴结清扫术的患者进行临床病理分析。结果:清除淋巴结1 682个,阳性率33.89%。原发性肿瘤大小及外侵程度(T)因素中T1、T2、T3、T4患者淋巴结转移率分别为22.33%、29.68%、28.77%、51.20%。鳞癌淋巴结转移率为19.49%,腺癌淋巴结转移率为35.57%,腺鳞癌淋巴结转移率为37.65%,大细胞癌淋巴结转移率为70.59%。中央型与周围型肺癌的淋巴结转移率分别为35.28%和33.08%。各区淋巴结中10、7、5区转移频率较高,其中7区转移率最高。结论:NSCLC的淋巴结转移与原发肿瘤大小、外侵程度、病理类型、肿瘤发生部位均有密切关系。肺切除时行系统性纵隔淋巴结清扫是必要的。

Objective：To investigate the relationship between the size of primary tumor,extent of the carcinoma,pathologic classification,location of tumor and lymph node metastasis in non-small cell lung cancer（NSCLC）.Methods：One hundred and forty-five patients with NSCLC underwent pneumonectomy or lobectomy and lymphadenectomy.The law of lymph node metastasis was analyzed.Results：A total of 1 682 lymph nodes were removed,metastatic rates was 33.89%.The total lymph node metastatic rates of T1,T2,T3 and T4 diseases were 22.33%,29.68%,28.77% and 51.20%.The lymph node metastatic rates in squamous cell carcinoma were 19.49%.The lymph node metastatic rates in adenocarcinoma carcinoma were 35.57%.The lymph node metastatic rates in adensquamous carcinoma were 37.65%.The lymph node metastatic rates in large cell carcinoma were 70.59%.The total lymph node metastatic rates in central and peripheral lung cancer were 35.28% and 33.08%.There were higher frequencies of lymph node metastasis in 10,7,5 regions,and 7 region was the higher than others.Conclusion：The frequency of lymph node metastasis significantly was correlated with size of primary tumor,extent of the carcinoma,pathological classification,location of tumor in NSCLC.It is necessary to perform systemic lymphadenctomy during pulmonary resection.