【作者】 阚学峰； 张真发； 尤健； 苏延军； 宫立群； 李晓； 赵镇清； 王长利；

【Author】 Kan Xue- Feng,Zhang Zhen- Fa,You Jian,Su Yan-Jun,Gong Li - Qun, Li Xiao,Zhao Zhen - Qing, Wang Chang - Li Department of Pulmonary tumor,Tianjin Cancer Hospital, Tianjin Medical University, Tianjin

【机构】 天津医科大学附属肿瘤医院肺部肿瘤科；

【摘要】 目的:分析NSCLC淋巴结切除数量及不同淋巴结转移状态对预后的影响。方法:对象为1995年1月～2000年12 月于天津医科大学附属肿瘤医院接受手术同时切除淋巴结的1575例肺癌患者,分析淋巴结切除的数量、淋巴结转移范围、数量、转移比例。结果:淋巴结切除数量影响预后,N0期患者切除7～12LN者5年生存率优于1～6LN和大于12LN者(P= 0．001和0．021);N1-2患者切除淋巴结大于12LN者5年生存率优于1～6LN和7～12LN者(P=0．000和0．003);N0期患者5 年生存率优于N1、N2患者(P=0．000),N1期和“跳跃式”N2期患者5年生存率优于“连续式”N2期患者(P=0．003和0． 002);单站淋巴结转移者5年生存率明显优于多站淋巴结转移者(P=0．000);转移淋巴结数为1～2个者5年生存率明显优于大于2个者(P=0．000);淋巴结转移比例分为<25％,25％～50％,51％～75％,>75％四组,生存期依次降低。结论:淋巴结切除数量影响NSCLC预后,一般术中应切除7～12个淋巴结;淋巴结转移范围、数量及比例均影响NSCLC的术后生存期。更多还原

【Abstract】 Objective: To analyze the number and the status of metastasis of LNs dissected during surgery in NSCLC,and confirm their affection for the prognosis.Methods:Clinic data of 1575 inpatient cases in The Cancer Hospital of Tianjin Medical University,from 1995 - 2000,were retrospectively reviewed.To analyze the number and the different status of metastasis of LNs dissected . The Kaplan - Meier method was used for survival analysis. Results: The number of LNs dissected affected the prognosis , N0 patients with more than 7-12 LNs dissected during surgery compared with less than 6 LNs or more than 12 LNs had a significant increase in survival( P = 0.001,0.021) ;N1-2 patients with more than 12 LNs compared with less than 6 LNs or 7 - 12 LNs had a significant increase in survival(P = 0.000,0.003), the 5 - year survival rate of N0 patients was superior to the N1 and N2 patients (P = 0.000),the 5 -year survival rates of N0 and skip metastasis N2 patients were superior to the continuous metastasis N2 patients ; patients with single station metastatic LNs compared with multiple stations metastatic LNs had a significant increase in survival (P = 0.000);patients with 1-2 metastatic LNs compared with more than 2 metastatic LNs had a significant increase in survival (P = 0.000) ,the ratio of metastatic LNs was divided into four subgroup: <25%,25% -50%,51% -75%, > 75% , from < 25% to > 75%, the 5 - year survival rate was gradually lower. Conclusions: we think for NSCLC the number of LNs dissected during surgery should be 7 - 12, the range , numbers , ratio of metastatic LNs significantly affected the prognosis of NSCLC.更多还原