肺癌淋巴结转移规律的临床研究

目的 探讨原发性肺癌淋巴结转移频率，分布范围及特点，为广泛廓清提供依据。方法 按Ｎａｒｕｋｅ肺癌淋巴结分布图对３８６例肺癌病人施行了手术切除及广泛肺门、叶间及纵隔淋巴结廓清术。结果 清除淋巴结２６０３组，Ｎ１淋巴结转移率２０．１％，Ｎ２淋巴结转移率１６．２％。Ｔ１，Ｔ２，Ｔ３间淋巴结经差异非常显著。

Clinical study of lymph node metastasis in lung cancer

Objective To investigate the frequency,distribution and feature of lymph nodes metastasis in lung cancer as to provide evidence for extensive dissection of lymph nodes. Method 386 patients with lung cancer underwent surgery plus extensive dissection of hilar,inter lobor and mediastinal noodes according to the grouping system proposed by Naruke. Results A total of 2?603 groups of lymph nodes were removed.Metastatic rates of N 1 and N 2 nodes were 20.1% and 16 2%. Significant difference of lymph node metastasis existed among T 1,T 2 and T 3 patients(P<0 01). No cancer metastasized to mediastinum in T 1 squamous carcinoma. N 2 metastatic rates for squamous carcinoma,adenocarcinoma,small cell carcinoma and large cell carcinoma were 30 1%,44 1%,48 0% and 50 0%,respectively. 64 2% of N 2 nodes in squamous carcinoma localized to one single group. 46 2% of N 2 nodes in adenocarcinoma spread to more than 3 groups. Sloitary metastatic nodes accounted for 53 7% of N 2 nodes. 15 1% of N 2 positive cancer in upper lobes metastasized to lower mediastinum,while 53 1% of N 2 positive cancer in lower lobes spread to upper mediastinum. Conclusion Solitary and multiple metastasis are the characteristic of lymph nodes metastasis in lung cancer. The frequency of metastasis increases with the growth and invasion of tumor. Metastasis in adenocarcinoma occurs more frequently than in squamous carcinoma. Tumor at any site can metastasize to distant mediastinum.Except for T 1 squamous carcinoma,radical surgery can be achieved only by extensive dissection of intrapulmonary and ipsilateral mediastinal lymph nodes.