摘要
目的:探讨非小细胞肺癌(NSCLC)纵隔淋巴结转移方式。方法:回顾性研究1989年1月～1999年1月,淋巴结廓清术后病理证实的纵隔淋巴结转移(pN2)137例。分析临床病理因素与pN2的关系,应用Logistic回归分析判定纵隔淋巴结CT扫描阴性时(cN0-1)pN2有意义的预测指标;总结不同位置肺癌纵隔淋巴结转移的方式。结果:NSCLC无论病理类型和临床状态如何,均有纵隔淋巴结转移发生。纵隔淋巴结增大(cN2)和cT2或cT3腺癌患者转移的发生率较高(65.0%,75.0%)。纵隔淋巴结转移多为区域性(80.9%),跨区域纵隔淋巴结转移多数伴有隆凸下淋巴结受累。结论:对NSCLC应行纵隔淋巴结廓清,尤其对cN2和cT2、cT3腺癌。多数患者单独廓清区域纵隔淋巴结即可达到目的。建议手术中对肺门和隆凸下淋巴结冰冻病理检查,无转移时可不必廓清非区域纵隔淋巴结。
Objective:To elucidate the metastatic mode of mediastinal lymph node and de-termine the reasonable extent of mediastinal lymph nodes dissection in NSCLC.Methods:A ret-rospective study was carried out.One hundred and thirty -seven of patients with N 2 disease NSCLC who underwent surgical resection with systemic mediastinal nodal dissection were studied.Clinical predictors were identified by means of logistic regression analysis and the sites of metas-tasis were analysized.Results:Mediastinal lymph node metastasis could occur in patients with each of cTN status,however,it had a higher incidence in the patients with cN2disease.Adeno-carcinoma histology with T2orT3tumors was the important predictors of N 2 disease in patients with cN0-1disease on the basis of multivariate analysis.The site of N 2 was associated with the location of primary tumor.Metastasis occurred in regional mediastinal lymph node in most patients(80.9%).Subcarinal lymph node appeared to always was involved before non-regional mediastinal metastasis could occurred.Conclusion:Systemic mediastinal nodal dissection should be per-formed in the patients with NSCLC,especially in the patients with c-N2disease and adenocarci-noma histology with T2orT3tumors.If there were no hilar and subcarinal lymph node metastasis,the extent of mediastinal lymph nodal dissection might be limited to the regional mediastinal lymph nodes.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2003年第2期91-94,共4页
Chinese Journal of Clinical Oncology
