CI期周围型非小细胞肺癌纵隔淋巴结清扫范围的探讨

目的：探讨CI期周围型非小细胞肺癌（non-small cell lung cancer，NSCLC）纵隔淋巴结合理的廓清范围。方法：回顾性研究112例行系统性纵隔淋巴结廓清的CI期周围型NSCLC患者的临床资料，分析临床病理特征与纵隔淋巴结转移的关系。结果：16例患者术后病理证实为N2，占14．3％，腺癌、鳞癌患者的纵隔淋巴结转移的发生率分别为19．5％、8．6％，两者相比差异有统计学意义，P=0．021。IA期、IB期患者的发生率分别为7．5％、16．7％，两者相比差异有统计学意义，P=0．045。上叶肿瘤纵隔淋巴结转移77．8％在上纵隔，下叶肿瘤纵隔淋巴结转移71．4％在下纵隔，上、下叶肿瘤均可发生隆突下淋巴结转移。结论：CI期周围型NSCLC应行包括隆突下淋巴结在内的选择性区域纵隔淋巴结廓清。

Clinical research on reasonable dissection extent of mediastinal lymph nodes for peripheral non-small cell lung cancer of stage CI

Objective To investigate the reasonable dissection extent of mediastinal lymph nodes in peripheral non-small cell lung cancer (NSCLC) of stage CI. Method A retrospective study was carried on the data of 112 patients with peripheral NSCLC of stage CI undergoing radical surgery and systemic mediastinal lymph nodes dissection.Results Among all the 112 patients, N2 was found in 16 patients (14.3%) through postoperative pathological exam.The mediastinal lymph node metastasic rate of adenocarcinoma was 19.5%,and squamous cell carcinoma was 8.6%, the difference was significant (P=0.021).The mediastinal lymph node metastasic rate of stage IA was 7.5%, and stage IB was 16.7%,the difference was significant (P=0.045). 77.8% mediastinal lymph node metastasis of superior lobe tumor was in superior mediastinum, 71.4% mediastinal lymph node metastasis of inferior lobe tumor was in inferior mediastinum.Tumor in superior lobe or inferior lobe both could transfer to surcarinal node. Conclusion Regional mediastinal nodal and surcarinal nodal dissection should be routinely performed on patients with peripheral non-small cell lung cancer of stage CI.