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目的:探讨肺癌纵隔淋巴结转移的规律与特点。方法:对358例肺癌行肺切除加淋巴结廓清术,对其中132例N2肺癌病例的281组转移性纵隔淋巴结进行临床病理分析。结果:两组以上N2转移占62.1%,跳跃式转移占12.1%,左侧肺癌N2转移发生率较高的依次为5、7、6组淋巴结,右侧肺癌N2转移发生率较高的依次为4、7、3组淋巴结;瘤体越大N2转移发生率越高,肺癌分化程度越差,N2转移发生率越高;病理类型不同,N2转移发生率分别为:小细胞癌80.0%、腺癌45.1%、大细胞癌33.3%、鳞癌24.0%。结论:对N2肺癌行广泛、全面的纵隔淋巴结清扫是十分必要的。
Objective: To investigate the rules and characteristics of mediastinal lymph node metastasis in lung cancer. Methods: Thirty-five cases of lung cancer underwent pneumonectomy and lymph node dissection, and 281 cases of metastatic mediastinal lymph nodes from 132 cases of N2 lung cancer were analyzed clinically and pathologically. Results: Two groups of N2 metastasis accounted for 62.1%, leaping metastasis accounted for 12.1%, left lung cancer N2 metastases were higher incidence of 5,7,6 lymph nodes, right lung cancer N2 metastasis were higher 4, 7, and 3 lymph nodes. The higher the incidence of N2 metastasis was, the worse the degree of lung cancer differentiation was and the higher the incidence of N2 metastasis was. The different pathological types of N2 metastasis were as follows: 80.0% for small cell carcinoma, 45.1% of cancers, 33.3% of large cell carcinomas and 24.0% of squamous cell carcinomas. Conclusion: It is necessary to perform extensive and comprehensive mediastinal lymph node dissection for N2 lung cancer.