摘要
目的 探讨原发性肺癌淋巴结转移频度、分布范围及特点 ,为广泛廓清提供依据。方法 按Naruke肺癌淋巴结分布图对 386例肺癌病人施行了手术切除及广泛肺门、叶间及纵隔淋巴结廓清术。结果 清除淋巴结 2 6 0 3组。N1淋巴结转移率 2 0 .1% ,N2 淋巴结转移率 16 .2 %。T1、T2 、T3 间淋巴结转移率差异非常显著 (P <0 .0 1)。T1鳞癌无N2 转移。N2 转移率在鳞癌、腺癌、小细胞癌及大细胞癌分别为 30 .1%、44 .1%、48.0 %及 5 0 .0 %。 6 4.2 %鳞癌N2 转移为某一组淋巴结 ,腺癌有 3组以上转移者占46 2 %。跳跃式转移占N2 转移的 5 3.7%。N2 阳性上叶肺癌下纵隔转移占 15 .1% ,下叶肺癌上纵隔转移占 5 3.1%。结论 肺癌淋巴结转移具有跳跃性、多发性。瘤体增大及外侵淋巴结转移频度增加 ,腺癌比鳞癌转移频度高。任何部位的肺癌均可跨区域纵隔转移。除T1鳞癌外 ,只有广泛清除肺内。
Objective To investigate the frequency,distribution and feature of lymph nodes metastasis in lung cancer as to provide evidence for extensive dissection of lymph nodes. Method 386 patients with lung cancer underwent surgery plus extensive dissection of hilar,inter lobor and mediastinal noodes according to the grouping system proposed by Naruke. Results A total of 2?603 groups of lymph nodes were removed.Metastatic rates of N 1 and N 2 nodes were 20.1% and 16 2%. Significant difference of lymph node metastasis existed among T 1,T 2 and T 3 patients(P<0 01). No cancer metastasized to mediastinum in T 1 squamous carcinoma. N 2 metastatic rates for squamous carcinoma,adenocarcinoma,small cell carcinoma and large cell carcinoma were 30 1%,44 1%,48 0% and 50 0%,respectively. 64 2% of N 2 nodes in squamous carcinoma localized to one single group. 46 2% of N 2 nodes in adenocarcinoma spread to more than 3 groups. Sloitary metastatic nodes accounted for 53 7% of N 2 nodes. 15 1% of N 2 positive cancer in upper lobes metastasized to lower mediastinum,while 53 1% of N 2 positive cancer in lower lobes spread to upper mediastinum. Conclusion Solitary and multiple metastasis are the characteristic of lymph nodes metastasis in lung cancer. The frequency of metastasis increases with the growth and invasion of tumor. Metastasis in adenocarcinoma occurs more frequently than in squamous carcinoma. Tumor at any site can metastasize to distant mediastinum.Except for T 1 squamous carcinoma,radical surgery can be achieved only by extensive dissection of intrapulmonary and ipsilateral mediastinal lymph nodes.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2000年第1期10-12,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
肺肿瘤
淋巴结转移
淋巴结切除术
Lung neoplasms Lymph node metastasis Lymph node dissection
