原发性支气管肺癌纵隔淋巴结的外科处理

目的探讨原发性支气管肺癌外科治疗中纵隔淋巴结清扫的重要性。方法回顾性分析2002年3月~2007年3月132例IA~ⅢA期原发性支气管肺癌病例,总结其肿瘤病理类型和淋巴结转移的关系,并根据术中纵隔淋巴结清除方式分成纵隔淋巴结采样组(采样组)和纵隔淋巴结系统清扫组(清扫组),比较生存率的变化。结果不同肿瘤类型的淋巴结转移情况差异较大,其中腺癌比鳞癌更易发生淋巴结转移。清扫组3、5年生存率分别为57.1%和38.8%,明显高于采样组50.6%和28.9%。结论纵隔淋巴结清扫是肺癌外科治疗的关键,系统性纵隔淋巴结清扫可以延长肺癌患者生存时间。

THE SURGICAL TREATMENT OF MEDIASTINAL LYMPH NODE IN PRIMARY BRONCHOGENIC CARCINOMA

Objective To investigate the significance of mediastinal lymph node excision of patients with primary bronchogenic carcinoma. Method Retrospective analysis on 132 patients with lung cancer in stage IA～ⅢA from March 2002 to March 2007 was conducted to evaluate the relationship between pathological type of tumor and lymphatic metastasis. Reference to the difference of lymph node excision, all 132 cases were divided into the mediastinal lymph node sampling group(MLNSG) and the systematic mediastinal lymphadenectomy group(SMLG) and compared with the change of survival rates. Result The condition of lymph metastasis of various kinds of lung cancer is different. Among which the adenocarcinoma is more active than squamous carcinoma. The 3 years and the 5 years survival rates of SMLG is 57.1% and 38.8%, is higher than 50.6% and 28.9% in MLNSG respectively. Conclusion Mediastinal lymph node excision was the key of the surgical treatment in primary bronchogenic carrinoma. The systematic mediastinal lymphadenectomy can prolong survival in patients with lung cancer.