早期非小细胞肺癌淋巴结转移规律及清扫方式研究进展

^{210000 南京，东南大学附属中大医院胸心外科, Department of Cardiothoracic Surgery, the Affiliated Zhongda Hospital of Southeast University, Nanjing 210000, China,}

薛涛 (Tao XUE): moc.621@oateuxcire

薛涛, Tao XUE, E-mail: moc.621@oateuxcire

薛涛 (Tao XUE): moc.621@oateuxcire

Received 2019 Mar 15; Revised 2019 May 24; Accepted 2019 Jun 5.

Abstract

肺癌是目前我国发病率和死亡率均居首位的恶性肿瘤，其中以非小细胞肺癌为主要病理类型。淋巴结转移是非小细胞肺癌最常见和最主要的转移途径，也是影响肺癌分期和预后最重要的因素。由于目前通过现有手段术前很难准确判断早期非小细胞肺癌患者的淋巴结受累情况。因此，在早期非小细胞肺癌中，尤其是在临床Ⅰ期非小细胞肺癌患者中，淋巴结清扫方式一直存在很大争议。本文就非小细胞肺癌淋巴结转移的规律及清扫方式进行综述。

Keywords: 肺肿瘤, 淋巴结转移, 清扫方式

Abstract

Lung cancer is the malignant tumor with the highest morbidity and mortality in China. Non-small cell lung cancer is the main pathological type. Lymph node metastasis is the most common and primary metastatic pathway in non-small cell lung cancer. Acknowledged as the major factor determining tumor staging and prognosis. Unfortunately, it' s presently hard to make an accurate preoperative judgment on the lymph node metastasis of early stage non-small cell lung cancer. Consequently, there has been a long-standing controversy on lymph node sweeping for early stage non-small cell lung cancer, especially for those clinical stage Ⅰ. The regularity of non-small cell lung cancer lymph node metastasis and the ways of lymph node sweeping will be reviewed in this paper.

Keywords: Lung neoplasms, Lymph node metastasis, Cleaning method

Abstract

肺癌是我国目前发病率和死亡率均居首位的恶性肿瘤，肺癌的主要组织学类型为非小细胞肺癌（non-small cell lung cancer, NSCLC）（80%-85%），其中NSCLC主要分为鳞状细胞癌（25%）、肺腺癌（40%）和大细胞癌¹]。淋巴结转移是NSCLC最常见和最主要的转移途径。也是影响分期和预后的最重要因素。因此，准确评估淋巴结的病理状态对于指导手术方法的选择、制定合适的淋巴结清扫方案、判断预后、提高肺癌患者的生存率以及改善生活质量具有重要意义。然而，通过现有手段，术前很难准确判断早期NSCLC患者的淋巴结受累情况。因此，在早期NSCLC中，尤其是在临床Ⅰ期NSCLC患者中，淋巴结清扫方式一直存在很大争议。本文将对国内外NSCLC淋巴结转移规律和淋巴结清扫方式的相关研究结果进行综述。

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