非小细胞肺癌胸内淋巴结转移及放疗设野的研究  

Relationship between Intrathoracic Lymph Node Metastases and Designing Irradiation Portals for NSCLC

作　　者：赵丽华[1] 吴红宇[1] 张帆[1] 朱韧[1] 刘俊倩 姜格宁[2] 

机构地区：[1]上海市肺科医院放疗科，上海 200433 [2]上海市肺科医院胸外科，上海 200433

出　　处：《中国肿瘤临床》2000年第12期909-911,共3页Chinese Journal of Clinical Oncology

摘　　要：目的：探讨非小细胞肺癌（ＮＳＣＬＣ）胸内淋巴结转移的特点和范围，及其对合理的放疗布野的意义。方法：１９９６年１～１２月，１７５例ＮＳＣＬＣ行肺叶或全肺切除加同侧纵隔淋巴结清扫，对切除的７０７个淋巴结进行病理分析。结果：ＮＳＣＬＣ胸内淋巴结转移首先至肺内组、肺门组，然后至纵隔各区，纵隔各区淋巴结转移与原发肿瘤部位有关。术后１年以上叶肺癌所致上纵隔淋巴结转移的患者中７７．Objective To explore the pathological features of intrathoracic lymph node metastases and the significance of optimal radiotherapy for non－small cell lung cancer NSCLC． Materials and Methods From Jan． 1996 to Dec． 1996 175 cases of NSCLC were operated for lobectomy or pneumonectomy combined with the removal of mediastinal lymph nodes at the same side． The lymph nodes were examined pathologically and the results were analysed． Results The tumor metastasized the intralobar and hilar lymph nodes first and then to mediastinum． The metastasis of mediastinal lymph nodes was associated with the site of primary tumor． One year after surgery supraclavicular lympn node enlargement was found in 77．4％ patients of upper lung cancer accompanied with upper mediastinal metastases． There were appronimately same metastasis rates between upper mediastinum lymph nodes and subcarinal nodes for lung cancer in middle lobe． The metastasis of upper mediastinum lymph nodes was lack in lower lobe． 75％ metastasis of the only one group N2 was squamous cell carcinoma． The metastatic of the more than two groups N2 in adenocarcinoma and adeno－squamous cell carcinoma were 63．6％ and 54．5％ respectively P＜ 0．005 P＜ 0．05． The clinical N stage was different from the pathological N stage． Conclusion The accurate pathological N staging is helpful for designing the irradiation portals．

关 键 词：放射治疗 胸内淋巴结 转移 非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤] R730.55[医药卫生—临床医学]