右肺中下叶非小细胞肺癌转移至上叶间淋巴结的危险因素及其预后  

Risk factors and prognosis of patients with superior interlobar lymph node metastasis of non-small cell lung cancer located in the right middle or lower lobe

作　　者：陈亮[1,2] 李庆姝 葛明建 CHEN Liang;LI Qingshu;GE Mingjian(Department of Thoracic Surgery,The First Affiliated Hospital of Chongqing Medical University,Chongqing,400016,P.R.China;Department of Thoracic Surgery,The Second Affiliated Hospital of Army Medical University,Chongqing,400037,P.R.China;Department of Pathology,Chongqing Medical University,Chongqing,400016,P.R.China)

机构地区：[1]重庆医科大学附属第一医院胸心外科,重庆400016 [2]陆军军医大学附属第二医院胸外科,重庆400037 [3]重庆医科大学病理科,重庆400016

出　　处：《中国胸心血管外科临床杂志》2022年第12期1612-1617,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的分析右肺中叶或下叶非小细胞肺癌转移至上叶间淋巴结(11s组淋巴结)的危险因素及其预后。方法回顾性分析2015年1月—2020年7月重庆医科大学附属第一医院收治的157例右肺中叶或下叶非小细胞肺癌患者的临床资料,其中男98例、女59例,年龄23~86(60.01±10.58)岁。所有患者接受了肺叶切除术及系统性淋巴结清扫,同时接受了11s组淋巴结清扫。根据11s组淋巴结是否受累将患者分为11s(+)组和11s(–)组。结果11s组淋巴结受侵共31例,总转移发生率为19.75%,其中中叶肿瘤转移率为13.64%,下叶肺癌转移率为20.74%。11s组淋巴结转移的危险因素是2R+4R组淋巴结受侵(P=0.026);第7组淋巴结受累和下纵隔区淋巴结受累是影响患者预后的高危因素(P<0.05)。11s组淋巴结转移与否和肿瘤位置无关,并且不是影响无病生存期的独立因素。结论右肺中叶或下叶非小细胞肺癌手术治疗中都应该清扫11s组淋巴结。隆突下淋巴结及下纵隔淋巴结转移是右肺中叶或下叶肺癌术后无病生存期的影响因素。11s组淋巴结可能是右肺中叶或下叶肺癌发生2R+4R组淋巴结转移的中转站,值得进一步研究证实。Objective To examine the high-risk factors and prognosis of patients with superior interlobar lymph nodes(11s nodes)metastasis in non-small cell lung cancer(NSCLC)located in the right middle or lower lobe.Methods The clinical data of 157 patients with NSCLC in the right middle or lower lobe from January 2015 to July 2020 in our hospital were retrospectively analyzed,including 98 males and 59 females aged 23-86(60.01±10.58)years.The patients underwent lobectomy and systemic lymph node dissection along with dissection of 11s nodes.They were divided into a 11s(+)group and a 11s(–)group according to whether the 11s nodes were involved.Results There were 31 patients with invasion in the 11s nodes,and the overall incidence of metastasis was 19.75%,including 13.64%with middle lobe tumors and 20.74%with lower lobe tumors.The 2R+4R nodes involvement was the influencing factor associated with 11s nodes metastasis(P=0.026).The 7th nodes and the inferior mediastinal lymph nodes involvement were high-risk factors affecting the prognosis of patients(P<0.05).The 11s nodes metastasis had nothing to do with the location of the tumor,and it was not an independent factor affecting disease-free survival.Conclusion The 11s nodes may be a transit for 2R+4R nodes metastasis in the right middle or lower lobe lung cancer,and the 11s nodes should be cleared in the surgical treatment for NSCLC in either the middle or lower lobe of the right lung.The influencing factors for disease-free survival after surgery for lung cancer in the right middle or lower lobe are the metastasis of the subcarinal lymph nodes and the inferior mediastinal lymph nodes.

关 键 词：上叶间淋巴结 非小细胞肺癌 系统性淋巴结清扫 

分 类 号：R734.2[医药卫生—肿瘤]