【摘要】 目的 :评价不同的淋巴结廓清范围对cⅠA 期非小细胞肺癌 (NSCLC)预后的影响 ,为选择合理的术式提供依据。方法 :根据临床特征将 93例cⅠA 期NSCLC病人按 1∶1∶1配对 ,分成肺淋巴结廓清、选择性纵隔淋巴结廓清和系统性纵隔淋巴结廓清三组。Kaplan Meier法绘出生存曲线 ,Log rank检验比较生存的统计学差别。结果 :肺淋巴结廓清、选择性纵隔淋巴结廓清和系统性纵隔淋巴结廓清组的 5年生存率分别为 2 2 .6 %、4 8.1%和 5 1.6 %。肺淋巴结廓清组与两个纵隔淋巴结廓清组之间差别有显著的统计学意义 (P <0 .0 1)。结论 :对cⅠA 期非小细胞肺癌 ,为了达到根治的目的 ,应该行纵隔淋巴结廓清术 ,廓清范围应该以区域纵隔淋巴结为主更多还原

【Abstract】 Purpose:To evaluate the efficiency of mediastinal lymph nodes dissection (MLND) and to determine a reasonable extent of dissection in the treatment of patients with clinical stageⅠ A non small cell lung carcinoma (NSCLC). Methods:From January 1988 to June 1995, one hundred and forty seven patients with clinical stageⅠ A NSCLC were treated by surgery. All the patients were divided into three groups according to the type of procedure, that is, resection without MLND, resection with selective MLND and systematic MLND. According to their clinical characteristics patients in each group were matched and assigned once again, and 93 cases were enrolled. Survival rates were calculated by Kaplan meier method and survival curves were prepared and survival difference was compared by Log rank test. Results:Survival rates at 5 year of no MLND, selective MLND and systematic MLND groups were 22.6%, 48.4%, and 51.6%, respectively. Survival rates of two MLND groups were higher than that of no MLND group. Log rank test presented significantly statistical difference between them ( P <0.01). It was demonstrated that the prognosis of patients who underwent MLND was superior to those who did not undergo MLND. Conclusions:Mediastinal lymph nodes dissection should be done in patients with clinical stageⅠ A NSCLC. It seemed that selective MLND was superior to systematic MLND for the patients.更多还原