Lymph node metastasis of T1, T2 squamous carcinoma and adenocarcinoma of lung:characteristics and clinical significance
- VernacularTitle:T1、T2肺鳞癌及腺癌淋巴结转移特点及其临床意义
- Author:
LIYu
1
;
Hongxu LIU
;
Houwen LI
;
Yongxiao HU
;
Hongnian YIN
;
Zhenyuan WANG
Author Information
1. First Affiliated Hospital China Medical University
- Keywords:
Lung neoplasms;
Lymphatic metastesis;
Lymph node excision
- From:
Chinese Journal of Surgery
2000;38(10):725-727
- CountryChina
- Language:Chinese
-
Abstract:
Objectives To investigate the frequency, distribution and features of lymph nodes metastasis in T1/T2 squamous carcinoma and adenocarcinoma of lung, and to provide evidence for extensive dissection of lymph nodes．Methods 254 patients with T1/T2 squamous caroinoma and adenocarcinoma of lung underwent R2 surgery plus extensive dissection of hilar, interlobular and mediastinal lymph nodes according to the grouping system proposed by Naruke．Results A total of 1685 groups of lymph nodes were dissected． The metastatic rates of N1 and N2 were 20．0% and 10．2%． The differerce was very significant between T1 and T2 (P<0．01)． No, N2 metastasis was found in T1 squamous carcinoma． N2 metastatic rates were 22．0% in squamous carcinoma and 40．9% in adenocarcinoma (P<0．01)． 64．3% of squamous carcinomas spread to only one group of N2 nodes,and over 3 groups of lymph nodes were positive in 46．2% of adenocarcinonmas． Saltatory metastasis accounted for 57．5% of N2 metastasis． 13．6% of N2-positive tumors in the upper lobes metastasized to the lower mediastinum, whereas 51．6% of N2-positive tumors in the lower lobes spread to the upper mediastinum．Conclusions The frequency of lymph node metastasis increases with the growth of tumors． Metastasis occurs more frequently in adenocarcinoma than in squamous carcinoma． Tumor at any site can metastasize to the distant mediastinum． Except for T1 squamous carcinoma, radical surgery can be achieved only by extensive dissection of ipsilateral intrapulmonary and mediastinal lymph nodes．
