肺腺癌与鳞癌胸内淋巴结转移及其与临床病理参数的相关性分析  

Lymph node metastases of lung adenocarcinoma and squamous cell carcinoma and their relations with clinicopathological parameters

作　　者：蒋华勇[1] 刘克强[2] 谭健[2] 张富利[1] 王雅棣[1] 

机构地区：[1]北京军区总医院放疗科,北京100700 [2]北京军区总医院胸外科,北京100700

出　　处：《临床军医杂志》2014年第10期1024-1026,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨肺腺癌和鳞癌患者根治术后胸内淋巴结转移规律及其与临床各病理参数的相关性。方法回顾分析经我院手术治疗的140例肺鳞癌和腺癌患者肿瘤大小、病理类型、组织分级等临床病理参数,探讨不同病理参数情况下淋巴结转移的发生规律。结果淋巴结总转移率为46.4%(65/140),肿瘤大小与淋巴结转移发生率密切相关,T_1、T_2、T_3、T_4肺腺癌和鳞癌患者淋巴结转移发生率分别为28.6%、43.3%、75%、83.3%(P=0.008);肿瘤分化程度越低,淋巴结转移发生率越高,组织分级为Ⅰ、Ⅱ、Ⅲ级的肺腺癌和鳞癌患者出现淋巴结转移的比例分别为22.2%,42.3%,73.5%(P=0.001)。不同病理类型的非小细胞肺癌,胸内淋巴结转移发生率无统计学差异。结论肺鳞癌和腺癌有较高的淋巴结转移发生率,临床分期晚、肿瘤分化程度低的患者需要进行系统性淋巴结清扫,必要时需辅以放疗,提高治疗效果。Objective To analyze the rules of intrathoracic lymph node metastasis and its relationship with clinicopathological parameters in patients with lung adenoearcinoma and squamous cell carcinoma. Methods We retrospectively analyzed 140 patients with lung adenocareinoma and squamous cell carcinoma who had undergone surgical treatment, including such parameters as tumor size, pathologic type, histological grade, etc. The laws of lymph node metastasis with different pathological parameters were investigated. Results The total rate of lymph node metastasis was 46.4% （65/140） , closely related to tumor size and lymph node metastasis rate. The rates of lymph node metastases of T1 , T2, T3 and T4 lung adenoearcinoma and squamous cell carcinoma were 28.6% , 43.3% , 75.0% and 83.3% , respectively （P = 0. 008）. The lower the grade of tumor differentiation, the higher the incidence of lymph node metastasis. The incidences of the metastases of those with histological grade I , Ⅱand Ⅲ lung were 22.2% , 42.3% and 73.5% , respectively （P = 0. 001 ）. Conclusion Lung squamous cell carcinoma and adenocarcinoma has a high incidence of lymph node metastasis. The patients with advanced clinical stage and low tumor differentiation have to be treated with systemic lymph node dissection and auxiliary radiotherapy, in order to get improved outcomes.

关 键 词：肺肿瘤 鳞癌 腺癌 淋巴结转移 

分 类 号：R734.2[医药卫生—肿瘤]