肺癌纵隔淋巴结转移的临床病理探讨

目的 从病理学角度探索肺癌纵隔淋巴结（Ｎ２）转移的特点。方法 为３９８例肺癌患者施行根除性肺陈除淋巴结廓清术,对其中１６０例Ｎ２肺癌的３５２组纵隔转移淋巴结进行病理学研究。结果 肺癌Ｎ２转移可呈现单组、多组和跳跃式转移,分别占４１．２％、５８．８％和２９．３％。Ｎ２转移分布最密集的部位是第７组淋巴结,占４８．８％,其次是第４、３、５组淋巴结,分别占４５．６％,３１．３％和２５．６％;而且Ｎ２转移分

A clinicopathological study of mediastinal lymph node metastasis of lung cancer

Objective To investigate the characteristics of mediastinal lymph node metastasis of lung cancer from a view of pathology. Methods Radical pulmonectomy or lobectomy combined with extensive dissection of mediastinal lymph node was carrived out in 398 patients with lung cancr. N2 disease was diagnozed in 160 cases, and total 352 groups of mediastinal lymph node invaded were analyzed.Results N2 disease appeared as single group, multi groups and jumping form groups, comprising 41.2%,58.8% and 29.3% respectively. The highest metastatic site of lymph node was group 7 mediastinal lymph node, the followings were group 4, 3 and 5 lymph nodes, comprising 45.6%, 31.3% and 25.6% respectively. The N2 metastasis was highly correlated with the site, size, histological classification and cell differentiation of the cancer. An another characteristic of N2 metastasis was that the metastatic lymph node could invaded into the bronchial wall, especially in adenocarcinoma. Conclusion It is necessary to dissect the lymph nodes of the hilar and upper and lower mediastinum at the homolateral thoracic cavity extensively and completely. Attention should be paid to the bronchial wall invasion by the metastatic lymph nodes, too.