中华肿瘤杂志
中華腫瘤雜誌
중화종류잡지
CHINESE JOURNAL OF ONCOLOGY
2015年
4期
297-300
,共4页
臧若川%高树庚%赫捷%毛友生%薛奇%王大力%牟巨伟%赵峻%王永岗%刘向阳%谭锋维%赵格非%张倩%张默言%宋朋
臧若川%高樹庚%赫捷%毛友生%薛奇%王大力%牟巨偉%趙峻%王永崗%劉嚮暘%譚鋒維%趙格非%張倩%張默言%宋朋
장약천%고수경%혁첩%모우생%설기%왕대력%모거위%조준%왕영강%류향양%담봉유%조격비%장천%장묵언%송붕
癌,非小细胞肺%肿瘤分期%淋巴转移
癌,非小細胞肺%腫瘤分期%淋巴轉移
암,비소세포폐%종류분기%림파전이
Carcinoma,non-small-cell Lung%Neoplasm staging%Lymphatic metastasis
目的：探讨直径≤2 cm的临床T1a期非小细胞肺癌（ NSCLC）患者的临床病理特征与淋巴结转移的关系。方法回顾性分析行肺叶切除术及系统性淋巴结清扫术、直径≤2 cm的418例NSCLC患者的临床资料，采用Logisitc多因素回归分析影响淋巴结转移的独立因素。结果418例NSCLC患者中，经病理证实发生淋巴结转移25例。122例磨玻璃样病变患者均未发生淋巴结转移。行隆突下淋巴结清扫者399例，隆突下淋巴结转移7例。单因素分析结果显示，性别、吸烟史、淋巴结直径、磨玻璃样病变、分化程度和病变位置均与淋巴结转移有关（均P＜0．05）。多因素分析结果显示，淋巴结直径、分化程度和病变位置是影响NSCLC淋巴结转移的独立因素（均P＜0．05）。结论左肺病变、病理分化程度低、术前CT示淋巴结直径≥1 cm是影响NSCLC淋巴结转移的独立危险因素，术前应予重视且术中应行系统性淋巴结清扫；病理分化程度低、术前CT示淋巴结直径≥1 cm的患者，发生隆突下淋巴结转移概率较高，推荐行该区淋巴结清扫；对于直径≤2 cm磨玻璃样病变的患者，因极少发生淋巴结转移，推荐行选择性淋巴结清扫术。
目的：探討直徑≤2 cm的臨床T1a期非小細胞肺癌（ NSCLC）患者的臨床病理特徵與淋巴結轉移的關繫。方法迴顧性分析行肺葉切除術及繫統性淋巴結清掃術、直徑≤2 cm的418例NSCLC患者的臨床資料，採用Logisitc多因素迴歸分析影響淋巴結轉移的獨立因素。結果418例NSCLC患者中，經病理證實髮生淋巴結轉移25例。122例磨玻璃樣病變患者均未髮生淋巴結轉移。行隆突下淋巴結清掃者399例，隆突下淋巴結轉移7例。單因素分析結果顯示，性彆、吸煙史、淋巴結直徑、磨玻璃樣病變、分化程度和病變位置均與淋巴結轉移有關（均P＜0．05）。多因素分析結果顯示，淋巴結直徑、分化程度和病變位置是影響NSCLC淋巴結轉移的獨立因素（均P＜0．05）。結論左肺病變、病理分化程度低、術前CT示淋巴結直徑≥1 cm是影響NSCLC淋巴結轉移的獨立危險因素，術前應予重視且術中應行繫統性淋巴結清掃；病理分化程度低、術前CT示淋巴結直徑≥1 cm的患者，髮生隆突下淋巴結轉移概率較高，推薦行該區淋巴結清掃；對于直徑≤2 cm磨玻璃樣病變的患者，因極少髮生淋巴結轉移，推薦行選擇性淋巴結清掃術。
목적：탐토직경≤2 cm적림상T1a기비소세포폐암（ NSCLC）환자적림상병리특정여림파결전이적관계。방법회고성분석행폐협절제술급계통성림파결청소술、직경≤2 cm적418례NSCLC환자적림상자료，채용Logisitc다인소회귀분석영향림파결전이적독립인소。결과418례NSCLC환자중，경병리증실발생림파결전이25례。122례마파리양병변환자균미발생림파결전이。행륭돌하림파결청소자399례，륭돌하림파결전이7례。단인소분석결과현시，성별、흡연사、림파결직경、마파리양병변、분화정도화병변위치균여림파결전이유관（균P＜0．05）。다인소분석결과현시，림파결직경、분화정도화병변위치시영향NSCLC림파결전이적독립인소（균P＜0．05）。결론좌폐병변、병리분화정도저、술전CT시림파결직경≥1 cm시영향NSCLC림파결전이적독립위험인소，술전응여중시차술중응행계통성림파결청소；병리분화정도저、술전CT시림파결직경≥1 cm적환자，발생륭돌하림파결전이개솔교고，추천행해구림파결청소；대우직경≤2 cm마파리양병변적환자，인겁소발생림파결전이，추천행선택성림파결청소술。
Objective To explore the relationship between the lymph node metastasis and clinicopathological features in patients with clinical stage T1a non-small cell lung cancer ( NSCLC ) . Methods Clinicopathological data of a total of 418 patients who underwent lobectomy and systematic lymph node dissection were retrospectively analyzed.Logistic regression was used to analyze the relationship between lymph node metastasis and clinicopathological features.Resulst Lymph node metastasis was observed in 25 patients.There were 122 patients who were diagnosed as ground glass opacity with no lymph node metastasis.399 patients had subcarinal dissection, among them 7 patients were found to have lymph node metastasis.Univariate analysis showed that gender, smoking history, diameter of lymph node, ground glass opacity ( GGO ) , differentiation of the tumor and tumor site were the factors affecting lymph node metastasis ( all P<0.05) .Logistic regression analysis showed that diameter of lymph node, differentiation of the tumor and the site of lesion were independent risk factors for lymph node metastasis of NSCLC. Conclusions Tumor in the left lung, poor differentiation, and diameter of lymph nodes ≥1 cm on the preoperative CT image are independent risk factors for lymph node metastasis of NSCLC, hence we should pay attention before surgery and systematic lymph node dissection should be done.For patients with poor differentiation and lymph nodes≥1 cm, subcarinal lymph nodes dissection is recommended for the sake of higher possibility of lymph node metastasis.For patients with ground glass opacity≤2 cm, the lymph node metastasis is extremely rare, therefore, selective lymph node dissection is reconmmended.
