非小细胞肺癌肺内第12和13组淋巴结转移规律及临床意义

目的:探讨非小细胞肺癌肺内第12和13组淋巴结的转移规律及临床意义.方法:对141例行肺切除和淋巴结清扫术的非小细胞肺癌患者进行临床病理分析.结果:共取得淋巴结2154枚,平均每例15.3枚,转移率为13.1％.141例患者中55例有胸内淋巴结转移,其中N115例,N1+N2 28例,跳跃性N212例,转移率为39.0％.常规病理检测无纵膈及肺内淋巴结转移患者93例中检出单纯第12或13组淋巴结转移者7例,检出率为7.5％.T2期肺内第12和13组淋巴结转移率明显高于T1期(P＜0.05),第12和13组淋巴结在低分化及中分化肺癌中的转移率分别为25.0％和8.9％(P＜0.05),周围型肺癌肺内第12和13组淋巴结转移率要显著高于中央型肺癌(P＜0.05).结论:非小细胞肺癌肺内第12和13组淋巴结转移与原发肿瘤大小、临床病理类型及分化程度均有密切关系.对早期非小细胞肺癌患者第12和13组淋巴结进行病理检测,可以为临床工作提供重要的指导.

The metastatic patterns of nodal involvement in lymph node stations No.12 and No.13 in non-small cell lung cancer and their clinical signi cance

Objective: To investigate the metastatic patterns of nodal involvement in lymph node stations No. 12 and No. 13 in non-small cell lung cancer and their clinical significance. Methods: The clinicopathological characteristics of 141 patients undergoing pneumonectomy or lobectomy and lymphadenectomy for non-small cell lung cancer were analyzed. Results: The total number of resected lymph nodes was 2 154, and the mean number of dissected lymph nodes was 15.3 in each patient. The positive rate of lymph node involvement was 13.1%. Fifty-five patients were confirmed as having thoracic lymph node metastases out of 141 patients. The numbers of patients with nodal metastases of N 1 , N 2 and skip-N 2 were 15, 28 and 12, respectively. The metastatic rate was 39.0%. Seven patients with nodal involvement in lymph node stations No.12 or No.13 were identified from 93 patients without mediastinal and intrapulmonary lymph node metastases confirmed by routine pathological examination. The detection rate was 7.5%. The metastatic rate of lymph node stations No.12 and No.13 in patients with stage T 2 was obviously higher than that in patients with stage T 1 (P <0.05), and the metastatic rates of lymph node stations No.12 and No.13 in poorly and moderately differentiated lung cancer were 25.0% and 8.9%, respectively (P <0.05). The metastatic rate of lymph node stations No.12 and No.13 was much higher in peripheral lung cancer than in central lung cancer (P <0.05). Conclusion: The metastases of lymph node stations No.12 and No.13 were closely correlated with the size, pathological type and differentiation of primary tumor. The pathological examination of lymph node stations No.12 and No.13 in early-stage non-small cell lung cancer may provide a valuable guidance in clinical practice. [