中心型肺鳞癌侵及支气管壁深度与淋巴结转移相关性研究

目的研究中心型肺鳞癌侵及支气管壁的深度与淋巴结转移的相关性,为肺癌手术合理廓清淋巴结提供依据。方法按Naruke肺癌淋巴结分布图对128例中心型肺鳞癌行系统淋巴结廓清术,术后病理确定肿瘤侵及支气管壁深度及淋巴结是否转移。结果 128例患者中肿瘤侵及支气管粘膜和粘膜下层者无淋巴结转移;肿瘤侵及支气管软骨及肌层者淋巴结转移率为18.7%（5/27）,且以N1为主;肿瘤侵及支气管周围肺组织者淋巴结转移率为57.3%（47/82）,二者间有显著性差异（P〈0.01）。结论中心型肺鳞癌随着肿瘤对支气管壁浸润的加深,淋巴结转移率增加。当肿瘤侵及支气管周围肺组织时,纵隔淋巴结转移率明显增加,术中应廓清纵隔淋巴结。

Study on the Relevancy Between the Invasion Depth of Bronchus By Hilar Type Squamous Cell Carcinoma of Lung and the Lymph Node Megastasis

Objective To provide evidence for the reasonable dissection of lymph nodes in the operation of the lung cancer through the study on the relevancy between the invasion depth of bronchus by hilar type squamous cell carcinoma and the lymph node metastasis.Methods 128 patients of hilar type squamous cell carcinoma underwent the systematic dissection of lymph nodes according to the grouping system proposed by Naruke.The invaded depth of the bronchial wall by tumors and the lymph node matastasis were ascertained by pathology after operation.Results Among these cases,without lymph node metastasis occurred in which tumor invaded into bronchial mucosa and submucosa.When tumor invaded into bronchial cartilage nad muscle,the frequency of lymph metastasis is 18.7%(5/17);When tumor invaded the lung tissue surrounging the bronchus,the frequency of lymph nodes metastasis is 57.3%(47/82).There is significant difference between these two rates.Conclusion The deeper the tumor invaded the bronchial wall,the higher the frequency of lymph nodes metastasis occurs in the hilar type squamous cell carcinoma.When tumor invades into the lung tissue surrounding the bronchus,the frequency of mediastinum lymph nodes metastasis increases significantly,so mediastinum lymph nodes shall be dissected in the operation.