按第七版肺癌T分期和新分级与淋巴结转移关系分析

摘要

Objective: To investigate the relationship between the T staging and grading of the Seventh Edition and lymph node metastasis of lung cancer. Methods: Retrospectively analysize the clinical data,primary tumor size and lymph node metastasis of 442 lung cancer patients who received radical resection of primary tumor and systemic in-trathoracic lymph node disection . To analyse the collected data with SPSS software. Results: The total lymph node metastatic rate of 442 lung cancer patients was 39. 1%. The metastatic rates of pulmonary lymph node, mediastinal lymph nodes and both were 17. 6% ,7. 2% and 14. 3% ,respectively. The total lymph node metastatic rates in T1 ,T2 , T3 and T4 were 25.4% ,45.3% ,41.1% and 53.8%( P =0.002 ).The lymph node metastatic rate of T, was signifi-cantly different, compared with T2 , T3 and T4 , respectively. There were no differences between every two groups of T2 , T3 and T4. The N1 metastatic rates of T1 ,T2 ,T3 and T4 were compared by chi - square( P =0. 274 ). The N2 metastatic rates of T1 , T2 , T3 and T4 were compared by chi - square ( P = 0.001 ). The lymph node metastatic rates of T1a and T1b were 16.4% and 32. 0%( P = 0.043 ) , respectively. The lymph node metastatic rates of T2a and T2b were 43. 9% and 48. 1%( P >0. 05 ),respectively. Conclusion: There are significant differences in the lymph node metastatic rates of different T staging of the Seventh Edition, especially in N2. The lymph node metastasis of T1 is the lowest. Tumor size grading is relevant to lymph node metastatic rate which is significantly different in T1a and T1b ,but not in T2a and T2b.%目的:探讨第7版肺癌T分期和新分级与淋巴结转移的关系.方法:回顾性分析442例行根治性切除及淋巴结清除术的肺癌患者的临床资料、原发肿瘤大小、淋巴结转移情况,运用SPSS软件行数据分析.结果:442例肺癌淋巴结转移率为39.1%,其中肺内淋巴结转移率为17.6%,纵隔淋巴结为7.2%、既有肺内又有纵隔淋巴结转移为14.3%;T1、T2、T3、T4期的淋巴结转移率分别为25.4%、45.3%、41.1%、53.8%,4组间P=0.002.T1与T2、T3、T4间淋巴结转移率比较差别有显著性.T2、T3、T4间两两比较淋巴结转移率无显著差别.N1淋巴结转移例数T1、T2、T3、T4间 P=0.274.N2淋巴结转移例数T1、T2、T3、T4间P=0.001.T1a淋巴结转移率为16.4%,T1b淋巴结转移率为32.0%,两者P=0.043.T2a淋巴结转移率为43.9%,T2b淋巴结转移率为48.1%,P>0.05.结论:第七版肺癌T分期的不同,淋巴结转移率有显著差别,其差别主要在N2上,T1 淋巴结转移率最低.肿瘤大小的分级与淋巴结转移率有关,T1a与T1b比有显著差异,但T2a与T2b间无差别.