215例肺癌的胸内淋巴结转移规律及临床分析  

Clinical Analysis of the Characteristics of Thoracic Lymph Nodes Metastasis in 215 Patients with Lung Cancer

作　　者：谢昭华 肖家荣[2] 

机构地区：[1]务川县人民医院外一科,贵州务川564300 [2]贵阳医学院附属医院胸外科,贵州贵阳550004

出　　处：《肿瘤基础与临床》2009年第1期68-70,共3页journal of basic and clinical oncology

摘　　要：目的分析肺癌胸内淋巴结转移的方式和规律,以探讨可切除性肺癌胸内淋巴结合理的手术清扫范围。方法收集215例行根治性切除术的肺癌资料,分析其淋巴结转移的特点和规律。结果215例肺癌共清扫胸内1082组的3680个淋巴结,平均每例切除淋巴结17.1个。经病理检查证实其中198组的468个淋巴结存在癌转移,215例肺癌中94例有胸内淋巴结转移,转移率43.7%。围绕肺门或肺根部的11、10、7、5和4组淋巴结的转移频度比远离肺根部的9、6、8、3、2、1组淋巴结高。小细胞肺癌的淋巴结转移率明显高于非小细胞肺癌(P<0.05),淋巴结转移率随肿瘤增大而增加。肺上叶癌更易向上纵隔淋巴结转移,而肺下叶(包括中叶)可向上、下纵隔淋巴结转移。结论多数肺癌的淋巴结转移遵循由近及远、自下而上、由肺内经肺门再向纵隔的叶转移规律,纵隔淋巴结转移呈"跳跃式"较为常见。肺切除术时施行系统性胸内淋巴结清扫是必要的。Objective To analyze the metastatic characteristics of thoracic lymph nodes of patients with respectable lung cancer as to find reasonable dissection of thoracic lymph nodes. Methods Lobectomy or pneumomectomy was performed for 215 patients with lung cancer, the metastatic characteristics of lymph node were analyzed. Results 3 680 lymph nodes were resected from 1 082 groups of 215 patients, the mean number of dissected lymph nodes was 17. 1, 468 lymph nodes from 198 groups were confirmed to have metastasis. 94 patients were confirmed to have intrathoracic metastasis in 215 patients with lung cancer, the metastatic rates were 43.7%. The metastatic frequencies in groups around the hilar or lung root（11 , 10, 7, 5, 4） were higher than those of regions far from lung root（9, 8, 6, 3, 2, 1）. There was a remarkably higher metastatic rate of lymph nodes in small cell lung cancer than that in non-small cell lung cancer（ P 〈 0.05 ） , the metastatic rate was closely related to size of tumor. Mediastinal lymph nodes metastasis was used to upper mediastinum from upper lobe cancer, while both upper and lower mediastinums were the metastasis sites for lower lobe cancers（including middle lobe）. Conclusion Most of neoplastic metastases of lymph nodes spread from proximal to distal areas, lower to upper regions, and from the hilar to the mediastinal. Some mediastinal lymph nodes show a skipping pattern. It is necessary to perform systemic lymphadenectomy during pulmonary resection.

关 键 词：肺癌 淋巴结 转移 

分 类 号：R734.2[医药卫生—肿瘤]