Ⅲa期肺癌CT纵隔肺门淋巴结层厚改变与手术切除的关系

Clinical Study of a Lung Cancer Resectability Evaluated by Chest CT Manifestation

探讨Ⅲａ肺癌ＣＴ纵隔肺门淋巴结层厚改变与手术切除的关系。全组７０例Ⅲａ期肺癌患者分别以ＴＮＭ分类分组和不同手术结果分组，分别测量各组胸部ＣＴ肿瘤瘤体直径、纵隔肺门淋巴结受侵ＣＴ层厚。ＴＮＭ分类组Ｔ２Ｎ２、Ｔ３Ｎ１、Ｔ３Ｎ２瘤体直径分别为：４．０７±０．９２，６．３３±３．６９，４．９４±１．８３（ｘ±ｓｃｍ）（Ｐ＜０．０５）。纵隔肺门淋巴结层厚分别为：４．２３±２．９６，２．７６±１．２８，４．１８±２．０７（Ｐ＞０．０５）。不同手术组中根治性切除组、姑息性切除组以及手术探查组瘤体直径分别为：４．５５±１．９６，４．１８±１．６０，５．６２±３．２３（Ｐ＞０．０５），纵隔肺门淋巴结层厚分别为：３．１４±１．８９，４．３５±１．４１，５．０３±３．０５（Ｐ＜０．０５）。Ⅲａ期肺癌纵隔肺门淋巴结受侵、ＣＴ纵向厚度改变是影响手术切除的重要因素之一。

BJELTIVE To evaluate chest CT and its relation to possible surgical resection in a lung cancer patients. METHODS Seventy a lung cancer patients were classified into TNM groups as well as different surgical result group. The diameter of tumor, the proximity to mediastium and/or the hilum and the invasion of their lymph nodes on each group were measured. Comparing of these two groups was made if there was any difference which affected the surgical resection. RESULTS The diameters of tumor at T\-2N\-1, T\-2N\-2 and T3N\-2 on TNM group were: 4.070.92, 6.333.69, 4.941.83 ( s cm) (P<0.05). The proximities to mediastinum and/or the hilum and the invasion of their lymph nodes were: 4.232. 96, 2.761.28,4.182.07 ( P >0.05). On the contrary, the diameters of the tumor at the radical resection group, palliative resection group and thoractomy group on the different surgical group were: 4.551.96, 4.181.60, 5.623.23 ( P >0.05), and the proximities to mediastium and/or the hilum and the invasion of their lymph were: 3.141.89, 4.351.41, 5.033.05 ( P <0.05). CONCLUSION The variety of the proximity to mediastium and/or the hilum and invasion of their lymph nodes is one of the main factors which affect the surgical resectability in a lung cancer.