非小细胞肺癌13组、14组淋巴结转移规律探讨  

Study on the Correlation Factors of 13,14 Groups Lymph Node Metastasis of Non-small Cell Lung Cancer

作　　者：张磊[1] 布仁吉雅[1] 王宇飞[1] 韩巴特尔[1] 郭占林[1] Lei ZHANG Buren JIYA Yufei WANG Batel HAN Zhanlin GUO(Department of Thoracic Surgery,The Affiliated Hospital of Inner Mongolia Medical University, Huhhot 010050, China)

机构地区：[1]内蒙古医科大学附属医院胸外科,呼和浩特010050

出　　处：《中国肺癌杂志》2017年第4期248-252,共5页Chinese Journal of Lung Cancer

基　　金：内蒙古自治区自然科学基金项目(No.2014MS08102)资助~~

摘　　要：背景与目的淋巴结转移是影响肺癌肿瘤-淋巴结-转移(tumor-node-matastasis,TNM)分期的重要因素之一,在非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的手术中,13组、14组淋巴结因其隐藏于肺叶的深部而忽视做病理检测,影响术后病理分期准确性。本研究旨在探讨13组、14组淋巴结在NSCLC术中的阳性检出率及其对病理分期的影响。方法选取内蒙古医科大学附属医院100例NSCLC手术患者为研究对象,剖取胸内2组-12组、第13、14组淋巴结行病理检测,分析肿瘤的大小、部位、病理类型等因素与胸内淋巴结转移率的关系。结果 100例患者胸内淋巴结转移率为47.0%,10组-12组、N2淋巴结、13组、14组淋巴结阳性率有统计学差异(P<0.05);不同T分期13组、14组淋巴结漏检率有统计学差异(P<0.05);周围型与中央型NSCLC的N1期漏检率无统计学差异(P>0.05);不同病理类型肿瘤之间N1期漏诊率无统计学差异(P>0.05)。此外,发现有12例患者存在非肿瘤所在叶、段支气管旁淋巴结转移。结论临床上检测NSCLC 13组、14组与非肿瘤所在叶支气管旁淋巴结的转移情况十分必要,有利于获取术后准确的TNM分期,对于指导术后治疗意义重大。Background and objective Lymph node metastasis is one of the important factors affecting the tumornode-matastasis （TNM） staging of lung cancer. In patients with surgery, 13 groups and 14 groups of lymph nodes ignored because of the deep hidden in the lung. In this paper, the positive detection rate of 13 groups and the 14 groups of lymph nodes in non-small cell lung cancer （NSCLC） and their effects on pathological stage were studied. Methods 100 cases of NSCLC were collected from the Affiliated Hospital of Inner Mongolia Medical University as the research object, cut out the intrathoracic 2-12 group, 13, 14 lymph node metastasis rate for pathological examination, relationship factors of statistical analysis of the size of primary tumor, location, pathological type and lymph node. Results 100 cases of patients with intrathoracic lymph node metastasis rate was 47.0%, with the 10-12 groups lymph node, N2 lymph nodes, 13, 14 groups lymph node positive rate had significant differences （P〈0.05）; T stage 13, 14 groups of lymph node detection rate has statistically significant difference （P〈0.05）; peripheral and central NSCLC stage N1 undetected rate no statistical difference （P〉0.05）; various pathological types of tumors between N1 missed rate had no significant difference （P〉0.05）. In addition, 12 patients were found to have non-tumor-derived lobe lymph node metastasis. Conclusion It is necessary to detect the metastatic lymph nodes of 13,14 group and non-tumor-derived lobe in NSCLC. It is helpful to obtain accurate TNM staging and to guide postoperative treatment.

关 键 词：肺肿瘤 淋巴结 转移 

分 类 号：R734.2[医药卫生—肿瘤]