可切除性非小细胞肺癌纵隔淋巴结的转移规律

Mediastinal lymph node metastatic patterns for non-small cell lung cancer

目的：研究可切除性非小细胞肺癌（NSCLC）纵隔淋巴结的转移规律与肿瘤大小、病理类型和位置之间的相关性.方法：对2011年1月～2013年12月间于我院胸外科行根治性肺叶切除的335例NSCLC进行回顾性分析.结果：335例NSCLC患者纵隔淋巴结转移率较高的为第7组、第4组.右肺上叶与右肺中、下叶NSCLC相比更容易发生上纵隔淋巴结转移（P＜0.01）.T1期上叶NSCLC发生隆突下淋巴结转移几率较低,差异存在统计学意义（P＜0.05）.腺癌发生N2组淋巴结转移几率显著高于鳞癌（P＜0.01）.高分化NSCLC发生N2组淋巴结转移几率显著低于中、低分化NSCLC （P＜0.05）.结论：NSCLC的纵隔淋巴结转移规律与肿瘤发生部位、病理类型、原发肿瘤大小存在一定相关性.

Objective：To study the relationship between the pattern of mediastinal lymph node metastasis with the size of primary tumor,pathologic classification,location of tumor in patients with non-small cell lung cancer （NSCLC）and provide a theoretical basis for lymph node dissection of NSCLC.Methods：From January 2011 to December 2013,a total of 335 patients with NSCLC underwent radical resection of pulmonary carcinoma in the department of thoracic surgery were analyzed.Results：The metastatic frequencies in groups of No.7,4 were higher than those No.2,3,4,5,6,7,8,9.The distribution of mediastinal lymph node metastasis of right upper lobe cancer was significantly different with that of right middle lobe cancer,right lower lobe cancer（P＜0.01）.Subcarinal lymph node metastasis rate of lung upper tumor with T1 stage was lower than that of lung upper tumor with T2-4 stage （P＜0.05）.The N2 lymph node staging of patients with adenocarcinoma was higher than that of squamous cell carcinoma（P＜0.01）.The N2 lymph node metastatic rates of NSCLC with higher differentiation was lower than that of NSCLC with poor differentiation or middle differentiation NSCLC （P＜0.05）.Conclusion：There might be a relation between the pattern of mediastinal lymph node metastasis with the size of primary tumor,pathologic classification,location of tumor in patients with NSCLC.