非小细胞肺癌电视辅助胸腔镜手术与传统开胸根治术叶间淋巴结清扫效果比较  

Efficacy comparison of interlobar node dissection by video-assisted thoracoscopic surgery and thoracotomy in treatment of non-small cell lung cancer

作　　者：吴科杰[1] 方万强[1] 戚雅秀[1] 付春利[1] 邓国敏[1] 

机构地区：[1]广东医科大学附属开平市中心医院胸心外科,529300

出　　处：《肿瘤研究与临床》2017年第1期35-38,共4页Cancer Research and Clinic

摘　　要：目的：探讨叶间淋巴结在非小细胞肺癌手术中的检出率，比较电视辅助胸腔镜手术（VATS）与传统开胸根治术在叶间淋巴结清扫方面的效果。方法回顾分析2012年8月至2016年3月在广东医科大学附属开平市中心医院接受同一组同一名胸外科医生手术治疗的非小细胞肺癌患者108例，分析不同临床及病理分期患者叶间淋巴结的检出率及阳性转移率。再根据患者接受的手术方式分为传统开胸组和VATS组，对两组患者清扫出的叶间淋巴结数量进行比较。结果不同临床分期患者叶间淋巴结阳性转移率分别为：ⅠA期5.7%（2／35），ⅠB期5.0%（1／20），ⅡA期14.3%（3／21），ⅡB期13.3%（2／15），ⅢA期29.4%（5／17）；不同病理T分期患者叶间淋巴结阳性转移率分别为：T1A期8.3%（2／24），T1B 期9.1%（2／22），T2A期12.9%（4／31），T2B期14.3%（2／14），T3期21.4%（3／14），T4期33.3%（1／3），总的转移率为13.0%（14／108）。在不同病理T分期及病理总分期患者中，传统开胸组与VATS组清扫叶间淋巴结数量比较，差异均无统计学意义（均P〉0.05）。结论即使是临床早期肺癌患者，叶间淋巴结也可能发生转移；叶间淋巴结转移率与肺癌病理T分期呈正相关。 VATS在叶间淋巴结清扫方面可以达到与传统开胸根治术同样的效果。Objective To investigate the positive detective rate of interlobar node in the operation of non-small cell lung cancer （NSCLC）, and to compare the effect of interlobar node dissection by video-assisted thoracoscopic surgery （VATS） with thoracotomy in treatment of lung cancer. Methods 108 patients with NSCLC who received the surgery by the same group of thoracic surgeons were collected from Aug 2012 to Mar 2016 in Guangdong Medical University Affiliated Kaiping Central Hospital. The positive transfer and detective rates of interlobar node in patients with different clinical and pathological stage were analyzed. Then the patients were divided into traditional open thoracotomy group and VATS group according to the operation mode, meanwhile, the number of interlobar nodes dissection in the two groups were compared. Results The positive transfer rates of the interlober nodes in patients with different clinical stage were ⅠA 5.7 % （2/35）,ⅠB 5.0 % （1/20）, ⅡA 14.3 % （3/21）, ⅡB 13.3 % （2/15）, ⅢA 29.4 % （5/17）; For patients with different pathological T stage were T1A 8.3 % （2/24）, T1B 9.1 % （2/22）, T2A 12.9 % （4/31）, T2B 14.3 % （2/14）, T3 21.4 %（3/14）, T4 33.3 % （1/3）, and over-all transfer rate was 13.0 % （14/108）. In pathology stage and pathology T stage, the number of interlober nodes had no statistical difference in traditional open thoracotomy group and VATS group （all P〉0.05）. Conclusions Even in the early clinical stage, the transfer of interlobar node may be positive. The transfer rate of interlobar node is correlated positively with pathology T stage. VATS can achieve the same effect in interlobar node dissection compared with the traditional approach.

关 键 词：癌 非小细胞肺 叶间淋巴结 电视辅助胸腔镜手术 开胸手术 

分 类 号：R734.2[医药卫生—肿瘤]