非小细胞肺癌(NSCLC)纵隔淋巴结转移规律探讨  

Clinical characteristics of mediastinal lymph node metastasis in non-small cell lung cancer(NSCLC)

作　　者：曾海[1] 钟亚华[2] 谢丛华[2] 高敏[2] 

机构地区：[1]荆州市第一人民医院肿瘤科,湖北荆州434000 [2]武汉大学中南医院放化疗科,湖北武汉430071

出　　处：《现代肿瘤医学》2013年第2期336-339,共4页Journal of Modern Oncology

摘　　要：目的:探讨不同肺叶非小细胞肺癌(NSCLC)纵隔淋巴结转移规律,为NSCLC辅助放疗靶区勾画提供参考。方法:对193例伴纵隔淋巴结转移的单叶NSCLC患者初次抗肿瘤治疗之前的胸部CT进行分析。结果:左侧NSCLC转移至同侧和对侧的概率相近,而右侧NSCLC主要转移至同侧上纵隔,两侧有统计学差异(P=0.016)。其中左下叶NSCLC更易转移至对侧上纵隔,而右下叶NSCLC主要转移至同侧上纵隔(P=0.007)。结论:建议左上叶NSCLC辅助放疗靶区包括10L、5、4R、4L、6、7、2R区,左下叶NSCLC辅助放疗靶区包括7、10L、4R、6、2R、4L区,右上叶NSCLC辅助放疗靶区包括4R、10R、7、2R、3a、4L区,右中叶NSCLC辅助放疗靶区包括10R、7、4R、2R区,右下叶NSCLC辅助放疗靶区包括10R、7、4R、2R、4L区。Objective：To find the reasonable adjuvant irradiation target volume by investigating the clinical characteristics of lymph node metastasis in different lobes of NSCLC. Methods： To analyze the chest CT findings of 193 patients with single lobe NSCLC before the first cancer treatment. Results： Lymphatic metastasis from left lung to the superior mediastinum was both ipsilateral and contralateral, whereas that of the right lung was frequently ipsilateral （P = 0. 016）. The major contribution to this spread to the opposite side of the mediastinum from the left lung comes from malignant lesions in the left lower lobe（ P = 0. 007 ）. Conclusion： We suggest that adjuvant irradiation target volume should include zones 10L,5,4R,4L,6,7,2R in patients of left upper lobe NSCLC ,zones 7,10L,4R,6,2R,4L in patients of left lower lobe NSCLC, zones 4R, 10R,7,2R,3a,4L in patients of right upper lobe NSCLC, zones 10R,7, 4R,2R in patients of right middle lobe NSCLC ,zones 10R,7,4R,2R,4L in patients of right lower lobe NSCLC.

关 键 词：非小细胞肺癌(NSCLC) 纵隔淋巴结转移 辅助放疗 CT 

分 类 号：R734.2[医药卫生—肿瘤]