【摘要】 目的：探讨非小细胞肺癌NSCLC胸内淋巴结转移的特点和范围及其对合理的放疗布野的意义。方法：1996年1~12月，175例NSCLC行肺叶或全肺切除加同侧纵隔淋巴结清扫，对切除的707个淋巴结进行病理分析。结果：NSCLC胸内淋巴结转移首先至肺内组、肺门组，然后至纵隔各区，纵隔各区淋巴结转移与原发肿瘤部位有关。术后1年内上叶肺癌所致上纵隔淋巴结转移的患者中77．4％24／31出现锁骨上淋巴结肿大。中叶肺癌上纵隔与隆突下淋巴结转移机率大致相等。下叶肺癌上纵隔淋巴结转移少见。鳞癌以1组N2转移为主，占75％。腺癌和腺鳞癌则以≥2组N2为主，分别为63．6％和54．5％P＜ 0．005P＜ 0．05。临床N分期和病理N分期差异较大。结论：准确的病理学N分期，有助于指导NSCLC的放射治疗设野。更多还原

【Abstract】 Objective To explore the pathological features of intrathoracic lymph node metastases and the significance of optimal radiotherapy for non－small cell lung cancer NSCLC． Materials and Methods From Jan． 1996 to Dec． 1996 175 cases of NSCLC were operated for lobectomy or pneumonectomy combined with the removal of mediastinal lymph nodes at the same side． The lymph nodes were examined pathologically and the results were analysed． Results The tumor metastasized the intralobar and hilar lymph nodes first and then to mediastinum． The metastasis of mediastinal lymph nodes was associated with the site of primary tumor． One year after surgery supraclavicular lympn node enlargement was found in 77．4％ patients of upper lung cancer accompanied with upper mediastinal metastases． There were appronimately same metastasis rates between upper mediastinum lymph nodes and subcarinal nodes for lung cancer in middle lobe． The metastasis of upper mediastinum lymph nodes was lack in lower lobe． 75％ metastasis of the only one group N2 was squamous cell carcinoma． The metastatic of the more than two groups N2 in adenocarcinoma and adeno－squamous cell carcinoma were 63．6％ and 54．5％ respectively P＜ 0．005 P＜ 0．05． The clinical N stage was different from the pathological N stage． Conclusion The accurate pathological N staging is helpful for designing the irradiation portals．更多还原