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目的探讨非小细胞肺癌(NSCLC)纵隔淋巴结N2跳跃性转移的临床特点,为N2转移性肺癌纵隔淋巴结合理的清扫范围提供理论依据。方法收集我院2000~2004年行根治性肺叶(或全肺)切除及系统性胸内淋巴结廓清术的275例NSCLC患者的临床资料,回顾性分析其中36例跳跃性N2的病理类型与原发肿瘤部位、大小的关系,并比较跳跃组与非跳跃组的淋巴结转移范围。结果跳跃性N2的发生率腺癌高于鳞癌(P=0.044),T1、T2期高于T3期(P=0.035),周围型肺癌高于中央型肺癌(P=0.030);跳跃性N2转移多局限于1个区域,与非跳跃性N2比较差异有统计学意义(P=0.000)。结论跳跃性N2多发生于周围型肺癌,T1、T2期肿瘤多见,病理类型多为腺癌,纵隔淋巴结转移多局限于单个区域。
Objective To investigate the clinical features of N2 jump metastasis in mediastinal lymph nodes of non-small cell lung cancer (NSCLC) and to provide a theoretical basis for the dissection range of mediastinal lymph node in N2 metastatic lung cancer. Methods The clinical data of 275 NSCLC patients with radical lobectomy (or whole lung) resection and systemic thoracic lymph node dissection in our hospital from 2000 to 2004 were retrospectively analyzed. The pathological types of 36 patients with skip N2 were retrospectively analyzed. Tumor site, the size of the relationship between jumping group and non-jumping group lymph node metastasis. Results The incidence of skip N2 was higher in adenocarcinoma than in squamous cell carcinoma (P = 0.044), higher in T1 and T2 than in T3 (P = 0.035), higher in peripheral lung cancer than in central lung cancer (P = 0.030) Metastasis more limited to a region, compared with non-skip N2 was statistically significant difference (P = 0.000). CONCLUSION: Jumping N2 mostly occurs in peripheral lung cancer. Tumors in stage T1 and T2 are more common. Most of the pathological types are adenocarcinomas. Mediastinal lymph node metastasis is mostly confined to a single area.