临床肿瘤学杂志

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非小细胞肺癌淋巴结转移与临床病理特征及预后的相关性分析

林潇1,陈愉生2,李鸿茹2,曾敦煌3,吴燕玲4   

  1. 1 福建省立医院干部特诊二科 2 福建省立医院呼吸内科 3 福建医科大学附属第一医院呼吸内科 4 福建医科大学附属泉州市第一医院呼吸内科
  • 收稿日期:2015-03-30 修回日期:2015-07-19 出版日期:2015-12-31 发布日期:2015-12-31
  • 通讯作者: 陈愉生

Association of clinical pathological characteristics and prognosis with lymph node metastasis of non-small cell lung cancer

LIN Xiao, CHEN Yusheng, LI Hongru, ZENG Dunhuang, WU Yanling.   

  1. Association of clinical pathological characteristics and prognosis with lymph node metastasis of non-small cell lung cancer
  • Received:2015-03-30 Revised:2015-07-19 Online:2015-12-31 Published:2015-12-31
  • Contact: CHEN Yusheng

摘要: 目的 探讨非小细胞肺癌(NSCLC)患者淋巴结转移与临床病理特征及预后的相关性。
方法 回顾性分析2010年1月至2013年8月福建省立医院收治的154例接受肺叶或全肺切除+系统性淋巴结清扫术的NSCLC患者的临床资料,探讨肺癌患者胸内各组淋巴结转移频度,分析淋巴结转移与肺癌类型、原发部位、临床病理特征以及预后的相关性。结果 154例肺癌患者中,共清扫胸内淋巴结748组,其中有133组淋巴结存在转移癌,74例发生胸内淋巴结转移,转移率为48.1%。第4、5、6、10、11组淋巴结转移频度高于第1、2、3、7、8、9组淋巴结。中央型肺癌患者第10组淋巴结转移率明显高于周围型肺癌患者(51.2% vs. 28.4%,P<0.05)。肺下叶癌患者第7组淋巴结转移率明显高于肺上(中)叶癌患者。Ⅲ期肺癌患者总淋巴结转移率、跳跃性N2转移率明显高于Ⅰ、Ⅱ期肺癌患者,中央型肺癌患者总淋巴结转移率明显高于周围型肺癌患者。将淋巴结转移分为3组:无淋巴结转移(Ng0),1~3组淋巴结转移(Ng1),4~6组淋巴结转移(Ng2)。生存分析提示淋巴结分组、淋巴结分期、T分期、肺癌类型与肺癌预后显著相关。Cox回归分析显示淋巴结分组、淋巴结分期及T分期为影响肺癌患者预后的独立因素。结论 肺癌淋巴结转移多以肺叶、肺门或肺根部淋巴结转移频度高;肺癌淋巴结转移率与TNM分期、肺癌类型相关;淋巴结转移组数、淋巴结分期及T分期与肺癌患者预后密切相关。

Abstract: Objective To investigate the association of clinical pathological characteristics and prognosis with lymph node metastasis of non-small cell lung cancer(NSCLC).
MethodsData from 154 NSCLC patients receiving lobectomy or pneumonectomy with systematic lymph node dissection in Fujian Provincial Hospital from January 2010 to August 2013 were retrospectively reviewed. The frequency of intrathoracic lymph node metastasis in each group, and the relationship of tumor type, primary site, clinical pathological characteristics and prognosis with lymph node metastasis were analyzed.
ResultsA total of 748 groups of intrathoracic lymph node were removed in 154 cases of lung cancer patients. Metastasis occurred in 133 groups of lymph node. Intrathoracic lymph node metastasis occurred in 74 patients, the transfer rate was 48.1%. The 4,5,6,10,11 groups had a higher frequency of lymph node metastasis than 1,2,3,7,8,9 groups. The metastasis rate of hilar lymph node in central lung cancer patients was significantly higher than that of peripheral lung cancer(51.2% vs. 28.4%,P<0.05). Subcarinal lymph node metastasis rate of lower lobe cancer patients was higher than that of upper and middle lobe patients. The frequency of lymph node metastasis and skip N2 metastasis in patients with stage Ⅲ lung cancer were higher than those of lung cancer patients with stageⅠ and Ⅱ. The total rate of lymph node metastasis in central lung cancer patients was significantly higher than those of peripheral lung cancer. The metastasized lymph nodes were divided into 3 groups: one group without lymph node metastasis(Ng0), 1 to 3 groups with lymph node metastasis(Ng1), 4 to 6 groups with lymph node metastasis(Ng2). Survival analysis suggested that Ng, lymph node stage, T stage and lung cancer types were associatied with prognosis. Cox regression analysis showed that Ng, lymph node stage and T stage were independent factors of the prognosis of lung cancer patients. Conclusion The lymph node metastasis of lung cancer occurred more likely in interlobar, hilar and pulmonary root lymph node. The lymph node metastasis frequency of lung cancer was associatied with TNM stage and lung cancer types. Ng, lymph node stage and T stage were significantly related with prognosis of lung cancer patients.

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