非小细胞肺癌隆突下淋巴结转移特点和影响因素的临床分析

Clinical analysis of characteristics and influencing factors of subcarinal lymph node metastasis in non-small cell lung cancer

目的分析非小细胞肺癌(NSCLC)隆突下淋巴结转移特点及相关因素,为临床患者手术治疗提供一些借鉴。方法回顾性分析2014年8月至2016年8月间在本院接受治疗NSCLC患者185例,患者在手术前均进行腹部彩色超声波、胸部增强CT、头颅磁共振成像及骨扫描等检测,无转移且未进行辅助治疗;依据患者有无发生隆突淋巴结转移分成隆突淋巴结未转移组(133例)与隆突淋巴结转移组(52例),对隆突下淋巴结转移和患者病理特征、病理类型及肿瘤位置进行对比分析。结果隆突下有无淋巴结转移在不同病理类型和肿瘤位置间对比差异有统计学意义(P<0.05),病理类型中患者鳞癌出现隆突下淋巴结转移概率最高,肿瘤位置中,右肺下叶出现隆突下淋巴结转移概率最高。不同病理分期和不同肿瘤位置,隆突下淋巴结转移差异有统计学意义(P<0.05),随着患者病情T分期进展,各个位置隆突下淋巴结转移概率逐渐升高;患者肺中下叶出现隆突下淋巴结转移高于肺上叶,差异有统计学意义(P<0.05)。结论隆突下有无淋巴结转移与不同病理类型和肿瘤位置具有密切相关性,鳞癌、右肺下叶出现隆突下淋巴结转移概率最高,并随着患者病情T分期进展,转移概率会逐渐升高,为患者手术治疗提供临床依据。

Objective To analyze the characteristics and related factors of subcarinal lymph node metastasis in non-small cell lung cancer(NSCLC)and to provide some references for the surgical treatment of patients.Methods A total of 185 NSCLC patients admitted to our hospital from August 2014 to August 2016 were retrospectively analyzed.All patients underwent abdominal ultrasound,chest enhanced CT,cranial magnetic resonance imaging and bone scan before operation.Metastasis and no adjuvant therapy.According to the presence or absence of lymph node metastases,they were divided into the non-metastasis group(133 cases)and the lymph node metastasis group(52 cases).Their subcarinal lymph node metastasis and pathological features and types and tumor location were comparatively analyzed.Results There was significant difference in lymph node metastasis between different types of cases and tumor location(P<0.05).The pathological type of squamous cell carcinoma showed the highest rate of lymph node metastasis,and the right lower lobe of the lung was the highest probability of lymph node metastasis.There were significant differences in lymph node metastasis under different pathological stages and different tumor locations(P<0.05).With the progress of T stage,the metastasis rate of lymph nodes under each location increased gradually.Lower middle lobe lymph node metastasis was higher than upper lobe,and the difference was statistically significant (P< 0.05).Conclusion The presence or absence of lymph node metastasis under the carina is closely related to different pathological types and tumor locations. The probability of metastasis of the subcarinal lymph nodes is the highest in squamous cell carcinoma and right lower lobe, and the probability of metastasis will gradually increase as the patient s condition T progresses, which provides clinical basis for surgical treatment of clinical patients.