非小细胞肺癌淋巴结转移规律和清扫临床研究(1)
[摘要] 目的 探討非小细胞肺癌(NSCLC)淋巴结的转移规律和临床清扫方式选择。方法 回顾性分析该院2015年2月—2018年3月收治的164例NSCLC患者，共清扫1 083组淋巴结，分析肺癌分期、病理类型以及原发部位与淋巴结转移关系，同时探讨肺叶特异性淋巴结清扫方式(LND)、系统性淋巴结清扫方式(SML)对围手术期资料的影响。 结果 共清扫淋巴结1 083组，平均每例清除7.13组。其中有淋巴结有转移317组，转移率为29.27%。T1：57组，T2：676组，T3：299组，T4∶41组，淋巴结转移率分别为15.79%、25.89%、36.12%、60.98%，差异有统计学意义(χ2=14.450，P<0.01)。跳跃性N2在腺癌的发生率较高为55.77%。同时LND组在手术时间、术后胸腔引流量、术后拔管时间以及平均住院天数等方面均优于SML组，差异有统计学意义(P<0.05)。结论 非小细胞肺癌患者的淋巴结转移与 T 分期之间存在明显的关联，跳跃性纵膈淋巴结转移的发生率相对较高。同时肺叶特异性淋巴结清扫可以取得与系统淋巴结清扫相同的治疗效果，且创伤更小，应对其给予足够的重视，注意广泛清扫淋巴结，提高治疗效果。
[关键词] 非小细胞肺癌;淋巴结转移;淋巴结清扫
[中图分类号] R734.2 [文献标识码] A [文章编号] 1674-0742(2020)11(a)-0060-03
Clinical Study of Lymph Node Metastasis and Dissection of Non-small Cell Lung Cancer
ZHANG Wan-fei
Department of Thoracic Surgery， Quanzhou First Hospital， Quanzhou， Fujian Province， 362000 China
[Abstract] Objective To investigate the lymph node metastasis of non-small cell lung cancer (NSCLC) and the choice of clinical dissection methods. Methods Retrospective analysis of 164 NSCLC patients admitted to the hospital from February 2015 to March 2018， a total of 1 083 groups of lymph nodes were dissected， the stage， pathological type of lung cancer， and the relationship between the primary site and lymph node metastasis were analyzed， and the method of lung lobe-specific lymph node dissection(LND) and systemic lymph node dissection (SML) on perioperative data. Results A total of 1 083 groups of lymph nodes were removed， with an average of 7.13 groups removed per case. Among them， there were 317 groups with lymph node metastasis， and the metastasis rate was 29.27%. In the T1：57 group， T2：676 group， T3：299 group， and T4：41 group， the lymph node metastasis rates were 15.79%， 25.89%， 36.12%， and 60.98%， respectively. The difference was statistically significant(χ2=14.450， P<0.01). The incidence of skipping N2 in adenocarcinoma was 55.77%. At the same time， the LND group was better than the SML group in terms of operation time， postoperative thoracic drainage， postoperative extubation time and average hospital stay， the difference was statistically significant(P<0.05). Conclusion There is a significant connection between lymph node metastasis and T staging in patients with non-small cell lung cancer. The incidence of skipping mediastinal lymph node metastasis is relatively high. At the same time， pulmonary lobe-specific lymph node dissection can achieve the same therapeutic effect as systemic lymph node dissection， and with less trauma， enough attention should be given to it， and attention should be paid to extensive lymph node dissection to improve the treatment effect., http://www.100md.com(张万飞)
[关键词] 非小细胞肺癌;淋巴结转移;淋巴结清扫
[中图分类号] R734.2 [文献标识码] A [文章编号] 1674-0742(2020)11(a)-0060-03
Clinical Study of Lymph Node Metastasis and Dissection of Non-small Cell Lung Cancer
ZHANG Wan-fei
Department of Thoracic Surgery， Quanzhou First Hospital， Quanzhou， Fujian Province， 362000 China
[Abstract] Objective To investigate the lymph node metastasis of non-small cell lung cancer (NSCLC) and the choice of clinical dissection methods. Methods Retrospective analysis of 164 NSCLC patients admitted to the hospital from February 2015 to March 2018， a total of 1 083 groups of lymph nodes were dissected， the stage， pathological type of lung cancer， and the relationship between the primary site and lymph node metastasis were analyzed， and the method of lung lobe-specific lymph node dissection(LND) and systemic lymph node dissection (SML) on perioperative data. Results A total of 1 083 groups of lymph nodes were removed， with an average of 7.13 groups removed per case. Among them， there were 317 groups with lymph node metastasis， and the metastasis rate was 29.27%. In the T1：57 group， T2：676 group， T3：299 group， and T4：41 group， the lymph node metastasis rates were 15.79%， 25.89%， 36.12%， and 60.98%， respectively. The difference was statistically significant(χ2=14.450， P<0.01). The incidence of skipping N2 in adenocarcinoma was 55.77%. At the same time， the LND group was better than the SML group in terms of operation time， postoperative thoracic drainage， postoperative extubation time and average hospital stay， the difference was statistically significant(P<0.05). Conclusion There is a significant connection between lymph node metastasis and T staging in patients with non-small cell lung cancer. The incidence of skipping mediastinal lymph node metastasis is relatively high. At the same time， pulmonary lobe-specific lymph node dissection can achieve the same therapeutic effect as systemic lymph node dissection， and with less trauma， enough attention should be given to it， and attention should be paid to extensive lymph node dissection to improve the treatment effect., http://www.100md.com(张万飞)