摘要
目的 探讨肺癌淋巴结转移频度、分布及特点 ,为淋巴结清除术提供依据。方法 按Naruke肺癌淋巴结分布图对 348例肺癌病人施行根治性手术及系统性淋巴结清除 ,分析其淋巴结转移特点。结果 36 89组淋巴结N1转移率 2 34% ,N2 转移率 16 5 %。Tis期肺癌无淋巴结转移 ;T1期以后各期肺癌N1、N2 均可见转移 ;T1期、T2 期鳞癌和腺癌N2 转移率相比差异有显著性 ;淋巴结转移频度与T分期直线相关。肺下叶癌较肺上叶癌更容易转移至纵隔。肺上叶癌较肺下叶癌更容易发生跳跃式纵隔转移。结论 淋巴结转移腺癌比鳞癌活跃 ,小细胞肺癌最活跃 ,且随着T分期增加而增加 ;肺癌可跨区域纵隔转移 ;除T1期鳞癌不进行系统性淋巴结清除亦有可能达到根治目的外 ,其余类型肺癌均应进行系统性淋巴结清除。
Objective: To investigate the frequency , distribution and features of lymph node metastasis in lung cancer, and to provide evidence for lymph node dissection. Methods: 348 patients with lung cancer were retrospectively studied, all patients received R_3 surgery plus systemic lymph node dissection according to the mapping system developed by Naruke. Results: Total 3 689 groups of lymph nodes were dissected . The metastatic rates of N_1 and N_2 were 23.4% and 16.5%, respectively. N_1 or N_2 metastasis was not found in Tis tumor. There was a significant difference of N_2 metastasis rates between squamous cell carcinoma and adenocarcinoma in T_1 or T_2 tumor (P<0.01). There was close correlation between lymph node metastasis and T stage (r=0.9855). Salutatory metastasis accounted for 41.5% of N_2 metastasis. Lung cancers in lower lobes were more likely to spread to the mediastinum (P<0.05). Lung cancers in upper lobes are more likely to spread to the lower mediastinum. Conclusion: Patients with small cell carcinoma of the lung have highest risk of develop lymph node metastasis than that in adenocarcima and squamous cell carcinoma. Except T_1 squamous cell carcinoma are likely to be cured without lymph node dissection, the other stages of lung cancer ought to underwent systemic lymph node dissection.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2003年第5期275-277,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery