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了解肢体骨肉瘤患者的引流区淋巴结转移情况，分析其出现的原因及应采取的对策。方法 通过复习病历、手术记录和病理，回顾我院自１９８０年２月～１９９７年１０月肢体骨肉瘤患者的引流区淋巴结转移病程、化疗情况及当时所采取的措施。结果 ７２例患者中有７例出现引流区淋巴结转移，占 ９． ７％，保肢手术后引流区淋巴结转移５例，占 ９．４％（５／５３）。７例患者均未接受正规方案化疗，可能是导致淋巴结转移的重要原因。６例患者在发现淋巴结转移后半年至两年内死亡，１例经淋巴结清扫术已存活１２年。结论在骨肉瘤转移中，淋巴转移虽占较小比例，但应引起临床医生的重视，它同血行转移一样都是肿瘤发展至晚期的标志，一旦发生，推测预后不良。因此应尽早行根治性淋巴结清扫术，并辅以有效的化疗，争取挽救患者的最后机会。
To understand the status of lymph node metastasis in patients with limb osteosarcoma, analyze the reasons for its occurrence and the countermeasures that should be taken. Methods By reviewing medical records, surgical records and pathology, we reviewed the course of lymph node metastasis and chemotherapy in patients with limb osteosarcoma from February 1980 to October 1997 in our hospital and the measures taken at that time. RESULTS: Seven out of 72 patients developed lymphatic metastasis in the drainage area, accounting for 9. In 7%, lymph node metastasis in the drainage region after limb salvage was performed in 5 patients, accounting for 9.4% (5/53). None of the 7 patients received formal chemotherapy, which may be an important cause of lymph node metastasis. Six patients died within six months to two years after lymph node metastasis was detected, and one patient survived for 12 years after lymph node dissection. Conclusion In the metastasis of osteosarcoma, although lymphatic metastasis accounts for a small proportion, it should attract the attention of clinicians. It is the sign of tumor progression to the late stage as well as hematogenous metastasis. Once it occurs, the prognosis is poor. Therefore, radical lymphadenectomy should be performed as early as possible, supplemented by effective chemotherapy, in order to save the patient’s last chance.