系统性纵隔淋巴结清扫术在非小细胞肺癌分期中的重要性

目的 探讨系统性纵隔淋巴结清扫术在非小细胞肺癌分期中的作用。方法 对1998年3月-2002年3月34例非小细胞肺癌患者行肺叶或全肺切除术加系统性纵隔淋巴结清扫术，并对病例的临床TNM分期、术后TNM分期、区域淋巴结切除总数目、淋巴结转移比、淋巴结大小等5项指标进行评价。结果 34例病人中，术后分期改变16例，占47％(16／34)；共清扫纵隔淋巴结311枚，平均每例9．15枚；10例N2患者中清扫104枚纵隔淋巴结，32枚淋巴结有转移，其中7例为单区域转移(L1)，3例为2个区域转移(L2)；淋巴结转移比30．8％(32／104)；淋巴结的大小与是否转移无明显关系。结论 系统性纵隔淋巴结清扫术在非小细胞肺癌分期中具有十分重要的地位。系统性纵隔淋巴结清扫术应成为非小细胞肺癌根治性手术的标准。

The importance of systematic mediastinal lymphadenectomy in staging of patients with non-small cell lung cancer

Objective: To ascertain the importance of systematic mediastinal lymphadenectomy in staging of patients with non - small cell lung cancer. Methods: Between Mar. 1998 - Mar. 2002, 34 patients with non - small cell lung cancer received lobectomy or pneumotectomy with systematic mediastinal lymphadenectomy in our hospital. The difference between clinical staging and pathological staging, the amount of lymph nodes, the metastatic ratio of lymph node and the size of lymph node were evaluated. Results: Among 34 patients, staging was changed in 16 patients. In 10 patients with pathological N2, the metastatic ratio of lymph node was 30. 8% (32/104), 7 patients had one region metastasis, and 3 patients had two regions metastasis. There is no relationship between the size and metastasis in lymph node. Conclusion: Systematic mediastinal lymphadenectomy is importance in staging for patients with non-small cell lung cancer.