非小细胞肺癌Ｎ２跳跃性转移的临床研究

目的　探讨非小细胞肺癌（ＮＳＣＬＣ）纵隔淋巴结Ｎ２跳跃性转移的规律及特点，为肺癌完全切除加纵隔淋巴结清扫合理的廓清范围提供理论依据。方法　收集我科２００２年１月至２００２年１２月行肺癌完全切除加纵隔淋巴结清扫８３例ＮＳＣＬＣ患者的临床资料，选择其中４１例Ｎ２转移病例的临床资料，分为跳跃转移组１４例和非跳跃转移组２７例，回顾性分析比较两组临床资料情况。结果　Ｎ２跳跃性转移组最常见的病理类型为腺癌和腺鳞癌，Ｔ２最多，周围型肺癌多见，主要术式为肺叶切除。结论　行肺癌完全切除时，无论是否有肺门淋巴结的转移，都应行系统的纵隔淋巴结清扫。

Metastatic patterns in N2 lymphnodes area in non-small cell lung cancer

Objective To study the skipping metastatic pattern of mediastinal lymph nodes（N2）in patients of non-small cell lung cancer（NSCLC）,and to ascertain a rational model for the dissection of mediastinal lymph nodes.Methods From January 2002 to December 2002,eighty-three patients underwent operation of radical lofeetomy or pneumonectomy were analyzed retrospectively.Among those patients,41 patients were proved with metastatic mediastinal lymph N2 nodes,14 with skipping N2 nodes and 27 with no-skipping N2 nodes.Results Normally,the metastasis of N2 were frequently seen in adenocarcinoma or adenosquamous carcinoma,especially in peripheral type.Conclusion However,it is necessary to perform a systemic lymphadenectomy during pulmonary resection whether the patient is comparied by visible metastasis of N2 or not.