CAJ | 학술논문

目的：探讨非小细胞肺癌手术淋巴结清扫的范围。方法116例肺癌肺叶或一侧全肺切除术患者的手术结果进行回顾性分析。手术按肺癌淋巴结分布规律对区域性及非区域性淋巴结进行了根治性清扫，共清除同侧纵膈淋巴结（N2）淋巴结2366枚。手术切除的肺叶和淋巴结行病理切片检查，其中鳞癌46例，腺癌62 例，大细胞肺癌4例，腺鳞癌6例，其他4例。根据病理标本结果，对肿瘤部位、分型、大小、细胞分化程度等因素与淋巴结转移的关系进行分析研究。结果116例中57例（49．1％）存在N1或N2淋巴结转移以及N1、N2淋巴结共同转移。清除的2366枚纵隔淋巴结中转移的淋巴结（N2）426枚，纵隔淋巴结转移率18％。结论肺癌发生淋巴结转移机会很大，且与多种因素有关，如肺癌淋巴结转移与肺癌部位、细胞类型、肿瘤T分级和细胞分化程度都有密切关系。手术要达到根治目的，提供患者生存率，应进行系统性淋巴结清扫。
목적：탐토비소세포폐암수술림파결청소적범위。방법116례폐암폐협혹일측전폐절제술환자적수술결과진행회고성분석。수술안폐암림파결분포규률대구역성급비구역성림파결진행료근치성청소，공청제동측종격림파결（N2）림파결2366매。수술절제적폐협화림파결행병리절편검사，기중린암46례，선암62 례，대세포폐암4례，선린암6례，기타4례。근거병리표본결과，대종류부위、분형、대소、세포분화정도등인소여림파결전이적관계진행분석연구。결과116례중57례（49．1％）존재N1혹N2림파결전이이급N1、N2림파결공동전이。청제적2366매종격림파결중전이적림파결（N2）426매，종격림파결전이솔18％。결론폐암발생림파결전이궤회흔대，차여다충인소유관，여폐암림파결전이여폐암부위、세포류형、종류T분급화세포분화정도도유밀절관계。수술요체도근치목적，제공환자생존솔，응진행계통성림파결청소。
Objective To discuss the necessity of mediastinal lymphnode dissection in the resection of lung cancer .Methods 1 1 6 patients with lung cancer underwent lobectomy or pneumonectomy were retrospectivly analyzed .9 3 4 lymphnodes were removed and checked up pathologically .Results Lymphnodes with metastasic were confirmed in 5 7 ou t of the 1 1 6 cases ,and t he metastas is ratio was 4 9 .1% ,and among them in 4 3 patients suffered N 2 lesion ,with the ratio of 3 7 .1 % .The statistic result showed that lymp hnode metastasis was corre-lated to the location ,cell type ,t he size ,T stage and differntiation of lung cancer .Conclusion Lymphnode metastasis in lung cancer is common and related to multiple factors .It is important for systemic lymphadenec-tomy .