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目的探讨原发性肺癌胸内淋巴结转移规律及方式,为确定肺癌术中淋巴结清扫范围提供依据。方法按Naruke肺癌淋巴结分布图作为淋巴结清扫依据,对85例肺癌行完全性切除及广泛肺门、叶间及同侧纵隔淋巴结清扫术。结果 85例肺癌共清除淋巴结874枚。总转移率为58.8%(50/85),N_1占21.2%(18/85),N_2占37.6%(32/85),跳跃性N_2共9.4%(8/85)。分布在纵隔第1、2、4、5、6、7组淋巴结。结论淋巴结转移与肺癌大小、部位、病理类型有关。肺癌淋巴结转移具有多组别、多区域及跳跃性,肺癌早期淋巴转移在T_1期,所以,肺癌术中有必要常规胸内淋巴结清扫。
Objective To explore the rules and methods of primary lymph node metastasis in lung cancer and to provide basis for determining the extent of intraoperative lymph node dissection. Methods According to the lymph node distribution map of Naruke lung cancer as the basis for lymph node dissection, 85 patients with lung cancer underwent complete resection and extensive hilar, interlobular and ipsilateral mediastinal lymph node dissection. Results A total of 874 lymph nodes were removed from 85 patients with lung cancer. The overall metastasis rate was 58.8% (50/85), N_1 accounted for 21.2% (18/85), N_2 accounted for 37.6% (32/85), and skipping N_2 totaled 9.4% (8/85). Distribution in the mediastinal lymph nodes 1,2,4,5,6,7. Conclusion Lymph node metastasis is related to the size, location and pathological type of lung cancer. Lymph node metastasis of lung cancer has multiple groups, multiple regions, and skipping. Lymphatic metastasis in early stage of lung cancer is in T1 phase. Therefore, routine intrathoracic lymph node dissection is necessary during lung cancer surgery.