早期非小细胞肺癌淋巴结转移规律与清扫方式研究进展

摘要

Lung cancer ranks the ifrst position in morbidity and mortality among all malignances in China. Non-small cell lung cancer (NSCLC) accounts for nearly 80%of all lung malignancies. Surgical resection is still the current major treatment method for early stage NSCLC. Lymph node stages together with the extent of lymph node dissection directly affect the prognosis. Anatomical lobectomy with systematic mediastinal lymph node dissection have been the standard surgical treat-ment for NSCLC. However, it is controversial in the extent of lymph node dissection for early stage NSCLC. Accurate nodes stage and the extent of mediatinal nodes dissection affect the peri-operative complications and the prognosis of NSCLC greatly. In the past decade, more and more surgeons demostrated that lobe-speciifc or selective mediastinal lymph node dissection is suitable for clinical stage I NSCLC, especially the stage Ia lesions, and may become the standard lymph node dissection mode in the future.%目前，肺癌已是全球范围内发病率及死亡率最高的恶性肿瘤，非小细胞肺癌（non-small cell lung cancer, NSCLC）约占肺癌80%。手术治疗在早期NSCLC治疗中占主导地位，而淋巴结分期及手术中清扫程度直接影响着患者术后生活质量及患者的预后。解剖性肺叶切除加系统性淋巴结清扫一直以来被认为是NSCLC的标准手术方式，但对早期NSCLC患者纵隔淋巴结清扫程度问题上一直存在较大争议，精确评估区域淋巴结的转移及淋巴结清扫的程度是影响患者围手术期并发症和预后的重要因素。对于早期肺癌行肺叶特异性或选择性淋巴结清扫已逐渐为国内外学者接受，并可能成为临床I期NSCLC患者标准淋巴结清扫方式。