N1期非小细胞肺癌预后分析

目的 探讨非小细胞肺癌患者中N1的临床意义及与NO和N2的异同。方法 以1982年1月－1994年12月我院138例行根治性手术N1期NSCLC患者为研究对象，根据肺癌淋巴结分布图将N1分为叶内N1与叶外N2两亚组，与同期NO期307例、N2期176例行根治性手术NSCLC患者作比较，分析术后五年生存率。结果 138例N1期NSCLC患者五年生存率为30．4％，叶内N1与叶外N2两亚组五年生存率有显著性差别（50．3％比26．5％，P＝0．001），且叶内N1亚组与NO组五年生存率相似（51．4％比50．3％），而叶外N1亚组与单一区域N2期五年生存率相似（26．5％比23．5％）。结论 N1分为二亚组，叶内1亚组与NO期特性相似，叶外N1亚组与单一区域N2期特性相似。

PROGNOSTIC SIGNIFICANCE OFN1 STAGE IN NON-SMALL CELL LUNG CANCER

Objective To investigate the prognostic significance of N1 stage in non small cell lung cancer (NSCLC) by comparing is survival with N0 and N2 stages. Methods From Jan. 1982 to Dec. 1994, 138 NSCLC patients with surgical pathological N1 stage had received complete mediastinal lymph node dissection. Two subgroups of N1 node were identified by using New Regional Lymph Node Classification for Lung Cancer Staging. Their prognostic significances were tested and 5 year survival rates were compared with those of surgical pathological N0 (307 cases) and N2 (176 cases) patients received radical operation during the same period. Results The overall 5 year suvival rate of N1 patients was 30 4 %. five year survival was significantly better when N1 involvement was intralobar as compared with extralobar involvement, 50 3 % versus 26 5 % ( P= 0 001). Intralobar N1 5 year survival was similar to that of N0 (51 4 % vs 50 3 %), and extralobar N1 5 year survival was similar to that of N2 with singl focus (26 5 % vs 23 5 %). Conclusion N1 stage in NSCLC is a compound with two subgroups; the prognostic significance of intralobar subgroup is related to N0 stage and extralobar subgroup is related to that of single focus N2.