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目的 探讨Ⅲa 期肺癌胸部CT表现与手术切除可行性的关系。方法 全组 70例Ⅲa 期肺癌患者分别以CT TNM分类和不同术式分为 3组 ,分别测量各组胸部CT肿瘤瘤体直径、纵隔肺门淋巴结受侵CT层厚。结果 CT TNM分类组T2 N2 、T3N1和T3N2 瘤体直径分别为 4.0 7± 0 .92、6 .3 3± 3 .6 9和 4.94± 1.83 ( x±s)cm (P <0 .0 5 )。纵隔肺门淋巴结层厚分别为 4.2 3± 2 .96、2 .76± 1.2 8、4.18± 2 .0 7cm(P >0 .0 5 )。不同术式组中根治性切除组、姑息性切除组以及手术探查组瘤体直径分别为 4.5 5± 1.96、4.18± 1.6 0、5 .6 2± 3 .2 3cm (P >0 .0 5 ) ,纵隔肺门淋巴结层厚分别为 3 .14± 1.89、4.3 5± 1.41、5 .0 3±3 .0 5cm(P <0 .0 5 )。结论 Ⅲa 期肺癌纵隔肺门淋巴结受侵、CT纵向厚度改变是影响手术切除的重要因素之一。
Objective To investigate the relationship between chest CT findings and the feasibility of surgical resection in stage IIIa lung cancer. Methods Seventy patients with stage IIIa lung cancer were divided into three groups by CT TNM classification and different surgical methods. The diameter of CT chest tumors and the thickness of mediastinal hilar lymph nodes were measured in each group. Results The tumor diameters of T2 N2, T3N1, and T3N2 in the CT TNM classification group were 4.07±0.92, 6.33±3.69, and 4.94±1.83 (x±s)cm, respectively (P<0.05). . Mediastinal hilar lymph node layer thickness was 4.2 3 ± 2 .96, 2.76 ± 1.2 8, 4.18 ± 2 .0 7 cm (P > 0.05). The diameters of the tumors in the radical resection group, the palliative resection group, and the surgical exploration group in the different surgical groups were 4.5 5± 1.96, 4.18± 1.6 0, 5.62±3.23 cm, respectively (P > 0.05). The mediastinal hilar lymph node layer thickness was 3.14± 1.89, 4.3 5±1.41, and 5.00±3.0 cm (P < 0.05), respectively. Conclusion The invasion of mediastinal hilar lymph nodes and the change of CT longitudinal thickness in stage IIIa lung cancer are one of the important factors affecting surgical resection.