摘要
目的 :探讨淋巴结受侵的程度及转移的范围与Ⅲ期非小细胞肺癌 (NSCLC)预后的关系及Ⅲ期NSCLC的手术适应证。方法 :回顾分析 1988年～ 1998年间 ,淋巴结廓清术后病理诊断为纵隔淋巴结转移 (pN2 )的 136例NSCLC患者的临床资料 ,根据术前的淋巴结分期、淋巴结受侵的程度及转移的范围分组。Kaplan Meier计算生存率 ,绘出生存曲线、用Log Rank检验比较不同组别的生存差别。结果 :不同的临床、病理因素中 ,淋巴结受侵的程度对预后的影响最大。淋巴结结外转移组的五年生存率低于结内转移组 ,分别为 9.8%和 18.8%。Log rank检验显示两组间差别具有显著的统计学意义 (P <0 .0 5 )。结论 :淋巴结结外转移的N2 患者预后不良。对手术中纵隔淋巴结活检冰冻病理证实转移灶局限在淋巴结内者 ,可采取根治性切除 ;对于淋巴结转移已突破外膜者 。
Purpose:To investigate the relationship between involved extent of lymph node parenchyma and prognosis of patients with stageⅢ non-small-cell lung cancer (NSCLC) and define the appropriate surgical indications for the patients. Methods:From 1988 to 1998,one hundred and sixteen patients with NSCLC underwent systematic lymph node dissection and were diagnosed to have metastasis in mediastinal lymph node (N_(2) disease), whose clinical data were reviewed. According to the clinical and pathologic characteristics of the involved mediastinal lymph node, the patients were divided into subgroups. Survival rates were calculated and survival curves were prepared by Kaplan-Meier method. Survival differences among the subgroups were compared by Log-Rank test. Results:Involved extent of lymph node parenchyma had an important effect on the prognosis. In N_(2) disease with extra-capsular metastasis and intact capsule, 5-year survival rates were 9.8% and 18.8%, respectively. The survival difference between extra-capsular metastasis subgroup and inner-capsular metastasis subgroup was of statistical significance (P<0.05). Conclusions:Extra-capsular extension of mediastinal lymph node was an adverse factor for prognosis in patients with N_(2) disease. When metastasis was limited to inner-capsule confirmed by biopsy at thoracotomy, the complete resection should be done, while when extra-capsular extension of mediastinal lymph node was found the aim of surgical treatment should be palliative.[
出处
《中国癌症杂志》
CAS
CSCD
2004年第5期469-471,共3页
China Oncology
关键词
肺肿瘤
外科
纵隔淋巴结转移
预后
lung neoplasm
surgery
metastasis of mediastinal lymph node
prognosis
