肺腺癌纵隔淋巴结转移影像学规律及转移影响因素分析  

Analysis on imaging regularity and influencing factors of mediastinal lymph node metastasis of lung adenocarcinoma

作　　者：李胜华[1] 邹国荣 欧宁锋[1] 梁宇峰[1] 陈欣健[1] LI Shenghua;ZOU Guorong;OU Ningfeng;LIANG Yufeng;CHEN Xinjian(Department of Radiology,Hexian Memorial Affiliated hospital of Southern Medical University,Guangzhou 511400 China;Department of Oncology,Panyu District Central Hospital, Guangzhou 511400 China)

机构地区：[1]南方医科大学附属何贤纪念医院放射科,广东广州511400 [2]广州市番禺区中心医院肿瘤科,广东广州511400

出　　处：《现代仪器与医疗》2016年第6期4-6,34,共4页Modern Instruments & Medical Treatment

摘　　要：目的 :探讨肺腺癌患者纵隔淋巴结转移的CT影像转移规律及相关影响因素。方法 :2012年1月1日至2014年12月31日共收集101例经病理确诊的肺腺癌患者,患者入组治疗前均给予胸部CT平扫+增强检查。回顾性分析患者纵隔淋巴结的CT征象及影响因素。结果 :101例患者中纵隔淋巴结转移90例(89.1%),最常发生在10组(76.2%)、4组(69.3%)、7组(41.6%),其次多见于2组(31.7%)、5组(21.8%)、6组(20.8%)。其中单纯的N1、N2、N3及N2+N3转移率低(4%,4%,5%,3%)N1+N2转移率30.7%,N1+N2+N3转移率35.6%。单因素分析显示吸烟、原发灶大小、肺外转移、UICCT分期、UICCM分期为影响肺腺癌纵隔淋巴结转移的因素(P<0.05),多因素分析显示纵隔淋巴结转移与肺外转移密切相关(P<0.05)。结论 :肺腺癌纵隔淋巴结转移遵循由近及远、由肺门向纵隔、多站、逐站转移的规律,出现孤立性、跳跃性转移少见。纵隔淋巴结转移与肺外转移密切相关。Objective:The aim of this study was to discuss the CT imaging regularity and influencing factors ofmediastinal lymph node metastasis of lung adenocarcinoma.Methods:101cases of pathologically confirmed lungcancer patients from January1th,2012to December31th,2014were enrolled,they were all given chest CT scan plusenhanced scanning.CT features and influencing factors of mediastinal lymph nodes in patients with retrospectiveanalysis.Results:90cases of mediastinal lymph node metastasis in101lung adenocarcinoma patients(89.1%),mostoften occurred in the group10(76.2%),group4(69.3%),group7(41.6%),follwed group2(31.7%),group5(21.8%),group6(20.8%).Among them,the simple N1,N2,N3and N2+N3transfer rate was low(4%,4%,5%,3%),N1+N2transfer rate was30.7%,N1+N2+N3transfer rate was35.6%.Univariate analysis showed that smoking,primary tumorsize,pulmonary metastasis,UICCT staging and UICCM staging were the influencing factors of mediastinal lymph nodemetastasis in lung adenocarcinoma(P<0.05),multivariate analysis showed that mediastinal lymph node metastasiswas closely related to extrapulmonary transfer(P<0.05).Conclusions:Mediastinal lymph node metastasis of lungadenocarcinoma is in accordance with the regularity,from near to the distant,from hilum to mediastinum,multistationed,station by station,but isolated skip metastasis is rare.Mediastinal lymph node metastasis is closely related tothe metastasis of lung.

关 键 词：肺腺癌 淋巴结转移 胸部CT 

分 类 号：R445.2[医药卫生—影像医学与核医学]