早期非小细胞肺癌淋巴结清扫范围的探讨  

Lymph Node Dissection in Early-Stage Non-Small Cell Lung Cancer

作　　者：逄旭光[1] 蒋伟[1] 王群[1] 陈小科[1] 范虹[1] 

机构地区：[1]复旦大学附属中山医院胸外科,上海200032

出　　处：《中国临床医学》2012年第6期616-618,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨早期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的淋巴结清扫范围。方法:回顾分析2005年—2008年561例肿瘤最大径≤5 cm的cN0NSCLC患者的临床资料。所有患者均行肺叶切除及系统性淋巴结清扫术,比较不同肺叶肿瘤的纵隔淋巴结转移部位的情况。结果:在271例上肺叶肿瘤中,上纵隔淋巴结转移37例(13.7%),隆突下淋巴结转移8例(3.0%),下纵隔淋巴结转移2例(0.7%);在217例下肺叶肿瘤中,隆突下淋巴结转移的20例(9.2%),上纵隔淋巴结转移的11例(5.1%)。结论:肺叶特异性淋巴结清扫对于早期NSCLC患者是一种合理的淋巴结处理策略。Objective：To investigate the optimal range of nodal dissection in early-stage non-small cell lung cancer（NSCLC）. Methods：From 2005 to 2008, 561 patients with NSCLC of less than 5 cm in the diameter of tumor and NO stage underwent sur- gery with systematic nodal dissection （SND）. N2 disease was revealed histologically after surgery and patterns of lymph nodal metastasis was analyzed. Results： Among 271 patients with upper lobe tumors, superior mediastinal lymph nodes metastases were found in 37 patients （13.7%）, whereas subcarinal metastases were found in 8 patients （3.0%）, and inferior mediastinal involvements were found in only 2 patients （0.7%）. Among 217 patients with lower lohe tumors, subcarinal involvements were found in 20 patients （9.2%）, whereas superior mediastinal metastases were found in only 11 patients （5.1%）. Conclu- sion： Lobe-specific SND might be an effective and appropriate strategy for patients with early-stage NSCLC.

关 键 词：肺肿瘤 癌 淋巴结清扫术 

分 类 号：R734.2[医药卫生—肿瘤]