【摘要】 目的　探讨非小细胞肺癌 (NSCLC)纵隔淋巴结跳跃性与非跳跃性转移的临床特点及预后的差异。方法　以 1982～ 1994年间我院行手术治疗的 176例ⅢA期有纵隔淋巴结转移的NSCLC患者为研究对象 ,其中 5 3例不伴有肺门淋巴结转移 ,称为跳跃组 ;12 3例伴有肺门淋巴结转移 ,称为非跳跃组。将纵隔淋巴结分为 3个区域 ,分析两组患者淋巴结转移范围及其与生存率的关系。结果　在跳跃组中 ,有 49例 (92 5 % )纵隔淋巴结转移局限于 1个区域 (L1) ,而在非跳跃组中有 45例 (36 6 % )纵隔淋巴结转移扩至 2或 3个区域 (L2或L3)。跳跃组的 5年生存率为 2 9 3% ,高于非跳跃组(12 .2 % ,P =0 0 38) ,且在同一L1上 ,跳跃组 5年生存率 (32 1% )亦高于非跳跃组 (15 .3% ,P =0 0 42 )。结论　NSCLC患者纵隔淋巴结跳跃性转移为纵隔淋巴结转移病变中独特的一个亚群。更多还原

【Abstract】 Objective To ascentain if any difference exists in clincal characteristics between resected non small cell lung cancer (NSCLC) with either skip or ordinary mediastinal lymph node metastases.Methods Among 176 patients with stage ⅢAN2 disease between 1982～1994 treated in our hospital, 53 had no metastasis at the hilar lymfh nodes [skip(+) group] while 123 had [skip(-) group]. To investigate the extent of nodal involvement, the mediastinal lymph nodes were divided into three regions.Results In the skip(+) group,mediastinal node metastasis was found in only one region in 49 of the 53 patients(92.4%),whereas 45 of the 123 patients(36.6%) from the skip (-) group revealed medinastinal metastasis at two or three regions The overall survival rate at 5 years after operation was 29.3% in the skip(+) group and 12.2% in the skip (-) group ( P = 0.038).Furthermore,regarding patients with mediactint node metantion in one rejion, the skip(+) group had a better prognosis than the skip (-) group (32.1%vs 15.3%, P =0.042).Conclusion These results suggest that patients with skip mediastinal lymph node metastases represent a unique subgroup of N2 disease.更多还原