肺癌纵隔淋巴结转移剖析.docVIP

肺癌纵隔淋巴结转移剖析 　　[摘要] 目的：分析肺癌纵隔淋巴结转移情况，促进术前对肺癌纵隔淋巴结转移的诊断。方法：分析86例手术治疗并病理确诊为肺癌病例的纵隔淋巴结肿大情况，并与53例肺部非恶性病变的病例比较。进一步分析相关因素与纵隔淋巴结转移的关系。结果：肺部良恶性病变的纵隔淋巴结肿大发生率差异具统计学意义（P=0.00），肿大与不肿大的纵隔淋巴结其癌转移率（MLNMR）差异具统计学意义（P＜0.05）。肺癌纵隔淋巴结肿大部位主要发生在第2、3、5和7组。病程越长、原发病灶的T分级越高，则MLNMR越大(P＜0.05)，鳞癌、腺癌、小细胞癌的MLNMR依次增大（P＜0.05）, 有毛刺征者比分叶征、偏心空洞征及单纯包块者MLNMR都大（P＜0.05）。结论：肺癌纵隔淋巴结肿大和癌转移具有一定特征，掌握这些特征可以促进术前对纵隔淋巴结转移的诊断。 　　[关键词] 肺癌；纵隔淋巴结；转移 　　[中图分类号]R734.2 [文献标识码]A [文章编号]1673-7210（2007）10（b）-017-03 　　 　　Analysis of mediastinal lymph nodes metastasis(MLNM) in patients with lung cancer 　　LIU Si-jun1, GAN Yao-min1,LONG Hong-chuan1, SHI Yong1, KAN Qi-wei2 　　(1.Department of Cardiovascular Thoracic Surgery, The Second Peoples Hospital of Meishan, Meishan 620010, China; 2.West China Medicine School of Sichuan University, Chengdu 610041, China) 　　[Abstract] Objective: To promote pre-operative diagnosis of MLNM by analyzing the situation of MLNM in lung cancer patients. Methods: Studied the lymphomegaly of 86 cases who underwent surgical treatment and were pathologically diagnosed as lung cancer, and contrasted them with 53 nonm alignant pneumonopathy cases. Had a deeper study of the correlation between related factors and MLNM. Results: The difference of lymphomegaly rate between nonm alignant and m alignant pneumonopathy was significant (P=0.00).The difference of mediastinal lymph nodes metastasis rate(MLNMR) between lymphomegaly and normal-size lymph nodes was significant (P＜0.05).The lymphomegaly mainly located in the second, third, fifth and seventh groups. Cases with longer course or higher T had larger MLNMR(P＜0.05). MLNMR was on the raise from squamous cell carcinoma, adenocarcinoma to small-cell carcinoma(P＜0.05). MLNMR of those with sentus sign is larger than those with segment sign,cavitas sign or simple tumour（P＜0.05）. Conclusion: There are some characteristics about megaly and metastasis of mediastinal lymph nodes from lung cancer, grasping these characteristics can improve preoperative diagnosis