Research on lymph node metastasis of peripheral non-small cell lung cancer less than 2 cm in diameter and discussion on lymph node dissection
10.3760/cma.j.cn112434-20190930-00338
- VernacularTitle:直径小于2 cm周围型非小细胞肺癌淋巴结转移规律研究及淋巴结清扫方式探讨
- Author:
Xin YE
1
;
Songping CUI
;
Yi LIU
;
Bin YOU
;
Bin HU
;
Hui LI
Author Information
1. 首都医科大学附属北京朝阳医院 胸外科 100020
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2020;36(9):513-517
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the characteristics and clinical significance of lymph node metastasis of peripheral non-small cell lung cancer(NSCLC) with diameter ≤ 2 cm; to explore the possibility of regional mediastinal lymphadenectomy.Methods:Collect all patients’ data with peripheral NSCLC ≤2 cm from January 2017 to August 2018 in our hospital, there was no previous history of other malignant tumors. All patients underwent lobectomy, segmentectomy, or wedge resection, and mediastinal lymphadenectomy , and comprehensive analysis was performed based on pathological findings and clinical features.Results:Among the peripheral NSCLC with a diameter of ≤ 2 cm, metastatic degree and rate of mediastinal lymph nodes were low(0.67% and 1.87%, respectively). The lymph nodes metastatic rate of pGGO, mGGO and solid nodule were 0, 1.18% and 4.92%, respectively. The 11th group of lymph node metastasis was positively correlated with the solid components of lymph nodules( P=0.024). While lymph node metastasis had no significant correlation between gender, age, smoking history, size, location, and tumor type. The metastasis of the 11th group of lymph nodes was positively correlated with the 2nd, 3rd, 4th and 6th lymph nodes( P=0.014, Kappa value 8.406). Conclusion:For the operation of pGGO patients, mediastinal lymphadenectomy was not necessary, or maybe N1 lymph nodes sampling was enough. For the operation of mGGO or solid nodules, the surgeon can determine the lymphadenectomy scope according to the 11th-group lymph nodes frozen pathology result. If positive, the extent of lymph node dissection should be appropriately expanded; If negative, the lymph node dissection can be skipped, so as to reduce the complications.
