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肺癌纵隔淋巴结转移及广泛廓清的价值
引用本文:Li Y,Li H,Hu Y. 肺癌纵隔淋巴结转移及广泛廓清的价值[J]. 中华肿瘤杂志, 1997, 19(4): 303-305
作者姓名:Li Y  Li H  Hu Y
作者单位:中国医科大学第一临床学院胸外科
摘    要:
目的研究肺癌纵隔淋巴结转移(N2)频度、分布范围及特点,为广泛廓清提供依据。方法总结9年间手术切除386例肺癌患者的临床资料。术中按Naruke肺癌淋巴结分布图对肺门、同侧纵隔淋巴结进行广泛廓清。结果N2147例,占38.1%,清除转移N2289组。N2转移率在鳞癌、腺癌、小细胞癌及大细胞癌分别为30.1%、44.1%、48.0%及50.0%。肺上叶N271例,清除转移N2146组。上纵隔转移124组,占84.9%;下纵隔转移22组,占15.1%。肺下叶(包括中叶)N276例,清除转移N2143组。下纵隔转移67组,占46.9%;上纵隔转移76组,占53.1%。跳跃式转移79例,占N2转移的53.7%。跳跃式纵隔转移16例,占10.9%。结论肺癌纵隔淋巴结转移具有跳跃性、多发性。只有广泛清除了上下纵隔淋巴结,才有可能达到根治。

关 键 词:肺肿瘤  淋巴转移  淋巴结切除术  癌.鳞状细胞  癌.小细胞  腺癌

Metastases to the mediastinal lymph nodes in lung cancer and their extensive dissection
Li Y,Li H,Hu Y. Metastases to the mediastinal lymph nodes in lung cancer and their extensive dissection[J]. Chinese Journal of Oncology, 1997, 19(4): 303-305
Authors:Li Y  Li H  Hu Y
Affiliation:Department of Thoracic Surgery, First Affiliated Clinical Hospital, China Medical University, Shenyang.
Abstract:
Objective To study the metastatic frequency, distribution and feature of mediastinal nodes in lung cancer and to establish criteria for nodal dissection. Methods Clinical data of 386 patients who underwent resection of lung cancers in the past 9 years were analyzed retrospectively. Based on the distribution map of mediastinal lymph nodes developed by Naruke, ipsilateral hilar and mediastinal nodes were resected. Results 147 cases (38.1%) had mediastinal nodal involvement (N 2). A total of 289 groups of nodes were dissected. The rate of N 2 disease among squamous cell, adeno , small cell and large cell carcinomas was 30.1%, 44.1%, 48.0% and 50.0%, respectively. In 71 cases with N 2 disease in the upper lobes, 146 groups of N 2 nodes were resected, including 124 groups in the upper mediastinum (84.9%) and 22 groups in the lower mediastinum (15.1%). In 76 cases with N 2 nodes in the lower and middle lobes, 143 groups of N 2 nodes were dissected, including 76 groups in the upper mediastinum (53.1%) and 67 groups in the lower mediastinum (46.9%). Saltatory metastases occurred in 79 patients, accounting for 53.7% of N 2 nodes and in 16 cases that occurred in the mediastinum (10.9%). Conclusion The feature of mediastinal lymph node metastases in lung cancer may be saltatory and multiple. Cure can be achieved only after extensive dissection of the upper and lower mediastinal nodes.
Keywords:Lung neoplasms Lymphatic metastasis Lymph node excision Carcinoma   squamous Carcinoma   small cell Adenocarcinoma
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