T1肺鳞癌及腺癌纵隔淋巴结转移

Analysis of mediastinal lymph nodes metastasis in T1 pulmonary squamous carcinoma and adenocarcinoma

  • 摘要: 目的: 探讨T1肺鳞癌及腺癌淋巴结转移的规律和特点。方法: 按Naruke等肺癌淋巴结分布图对162例T1肺鳞癌及腺癌行肺切除加系统性纵隔淋巴结清除术患者进行回顾性临床分析。结果: 162例T1肺癌患者中22例出现纵隔淋巴结转移(N2淋巴结转移),N2转移率为13.6%(22/162)。瘤体直径≤1.5 cm组和1.6~3.0 cm组的N2转移率分别为2.8%和22.2%,其中瘤体直径≤1.5 cm鳞癌组未见N2转移。T1肺鳞癌及腺癌的N2转移率分别为5.6%和20.0%,差异显著。T1高、低分化肺鳞癌及腺癌的N2转移率分别为4.3%和23.2%,差异显著。结论:T1肺癌中,N2淋巴结转移频度与肿瘤瘤体大小、分化程度、病理类型相关,且存在跳跃式转移的特点。故针对T1肺鳞癌及腺癌行肺切除术时施行系统性纵隔淋巴结清扫是非常必要的。

     

    Abstract: Ojbective: To investigate the characteristics of mediastinal lymph nodes metastsis in T1 pulmonary squamous carcinoma and adenocarcinoma.Methods: 162 patients with T1 pulmonary carcinoma who underwent pulmonary resection plus system dissection of mediastinal lymph nodes were retrospectively analysized according to the mapping system developed by Naruke.Results: Of 162 patients,22 had mediastinal lymph nodes metastasized.Metastatic rate of N2 was 13.6%(22/162).N2 metastatic rates in T1 pulmonary carcinoma with maximum diameter less than 1.5cm and between 1.6cm~3.0cm were 2.8% and 22.2% retrospectively,and no N2 metastatic lymph node was found in group with maximum diameter less than 1.5cm.N2 metastatic rates in groups of squamous carcinoma and adenocarcinoma were 5.6% and 20% respectively,the difference being significant.N2 metastatic rates in groups of well-differentiated and poorly differentiated were 4.3% and 23.2% respectively,the difference being significant.Conclusion: In T1 pulmonary carcinomas,N2 metastatic rate is closely related with the tumor diameter,the degree of differentiation,the pathological type.It is necessary to perform systematic mediastinal lymphadenectomy during pulmonary resection for those patients.

     

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