非小细胞肺癌纵隔淋巴结转移的临床病理探讨

A CLINICOPATHOLOGIAL STUDY OF MEDIASTINAL LYMPH NODE METASTASIS OF NON-SMALL CELL LUNG CANCER

目的 :从病理角度探索非小细胞肺癌纵隔淋巴结 (N2 )转移的特点。方法 :为 10 0 3例非小细胞肺癌患者行肺切除及淋巴结清除术 ,对 334例 N2 淋巴结转移进行临床病理分析。结果 :病理类型与 N2 转移关系密切 ,鳞癌 N2 转移率显著低于腺癌、腺鳞癌 ;N2 转移率随肿瘤长径增加而增加 ;N2 转移淋巴结的分布范围较为广泛 ,最密集的部位是第 3、7、5组淋巴结 ;中心型肺癌 N2 转移率明显高于周围型肺癌。结论 :为获得根除性切除 ,广泛、彻底清除同侧肺门、支气管和纵隔淋巴结是十分必要的。

Objective:To investigate the characteristics of mediastinal lymph node metastasis of non small cell lung cancer from a view of pathology.Methods:Pulmonectomy or lobectomy combined with extensive dissection of mediastinal lymph node was carried out in 1 003 patients with non small cell lung cancer.Results:The N 2 metastasis was highly correlated with the histological classification,N 2 metastasis in squamous cell carcinoma was significantly lower than that in adenocarcinoma and adenosquamous carcinoma.The incidence of N 2 is in parallel with the size of the cancer,the greater diameter of the mass,the higher rate of N 2. The matastatic site of N 2 was extensive.The highest site of lymph node was group 3,7 and 5 lymph nodes. The N 2 metastasis in central lung cancer was significantly higher than that in peripheral lung cancer.Conclusion:It is necessary to dissect the lymph nodes of hilar and bronchial and mediastinum at the homolateral thoracic cavity extensively and completely.