通过增强CT评估肺癌患者纵隔转移淋巴结的分布及规律

目的:通过增强CT观察健康查体人群和肺癌患者的纵隔及肺内淋巴结变化情况,探讨不同类型、不同部位肺癌的淋巴结分布及可能的转移规律.方法:对2015年1月至6月进行增强CT检查的健康查体人群和病理确诊的肺癌患者,分别统计分析健康查体人群的纵隔及肺内淋巴结的大小及分布情况;不同类型、不同部位肺癌患者的纵隔及肺内淋巴结的大小及分布情况.结果:健康查体人群:人均淋巴结3.1个,以2、3、4、5区多见,右侧多于左侧,多为＜5 mm的小淋巴结,偶有5～10 mm的中等淋巴结,无＞10 mm的大淋巴结;肺癌患者纵隔淋巴结明显增多,以肿大淋巴结多见;小细胞肺癌淋巴结高于鳞癌、腺癌患者,常多达50枚以上;1-10区均可见大小不等淋巴结,肿大淋巴结以2、4、7、10区多见;无左右区别;与肺部肿瘤体积大小无明显相关;而鳞、腺癌患者纵隔淋巴结数目和大小与肿瘤大小、部位相关,肿瘤小者则淋巴结少,且肿大的淋巴结更少;肿瘤大者则纵隔各区均可见大小不等淋巴结,肿大淋巴结以4、7、10区常见.结论:健康查体人群可见淋巴结多为＜5 mm的小淋巴结;小细胞肺癌常见淋巴结数目多达50枚以上;鳞、腺癌的淋巴结变化情况和肿瘤大小、部位相关.结合淋巴结的数目与肿瘤大小、部位,能更好的对CT下肺癌患者的纵膈淋巴结进行全面探讨与评估.

CT images study of mediational lymph node metastasis in patients with lung cancer by enhanced CT

Objective:To study the distribution and possible metastasis in mediastinal and intrapulmonary lymph nodes in different types lung cancer by enhanced CT.Methods:A retrospective analysis of enhanced CT was performed on the normal population and patients who were pathologically confirmed as lung cancer examined from January to June 2015.The size and distribution of mediastinal and pulmonary lymph nodes in the normal population and in different types and different locations of lung cancer were counted respectively.The statistical analysis was made.Resuits:In normal population,the average number of mediastinal lymph nodes was 3.1.2,3,4,5 areas were more in common and right was more than left.Most of them were small lymph nodes (＜ 5 mm),occasionally were moderate lymph nodes(the minimum diameter 5-10 mm) and had not seen enlarged lymph nodes (the minimal path ＞ 10 mm) and no lymph nodes in the lungs.The number of mediastinal lymph nodes in patients with lung cancer was significantly increased,which more than tens of pieces were often seen and often happened in enlarged lymph nodes.The number of lymph nodes in small cell lung cancer was significantly higher than that in patients with squamous cell carcinoma and adenocarcinoma which the numbers was more than 50.The lymph nodes with different sizes were found in 1-10 area.Enlarged lymph nodes in 2,4,7,10 areas were more common.There was no significant difference and no obvious correlation with lung tumor size.The number and size of mediastinal lymph nodes were significantly associated with tumor size in patients with squamous and adenocarcinoma.When tumors were small,the number of visible lymph nodes were small,and the enlarged lymph nodes were few.When tumors were big,vary sized mediastinal lymph nodes were seen in all the regions,and the enlarged lymph nodes were found in 4,7 and 10 regions.Conclusion:There were more small lymph nodes in the normal population ＜ 5mm.The number of lymph nodes in small cell lung cancer is more than 50.The lymph node changes in squamous carcinoma and adenomatous carcinoma were associated with tumor size and location.The number of nodes combined with the size and size of the tumor could better assess lymph node metastasis in patients with lung cancer under CT.