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目的 探讨非小细胞肺癌 (NSCLC)纵隔淋巴结跳跃性与非跳跃性转移的临床特点及预后的差异。方法 以 1982～ 1994年间我院行手术治疗的 176例ⅢA期有纵隔淋巴结转移的NSCLC患者为研究对象 ,其中 5 3例不伴有肺门淋巴结转移 ,称为跳跃组 ;12 3例伴有肺门淋巴结转移 ,称为非跳跃组。将纵隔淋巴结分为 3个区域 ,分析两组患者淋巴结转移范围及其与生存率的关系。结果 在跳跃组中 ,有 49例 (92 5 % )纵隔淋巴结转移局限于 1个区域 (L1) ,而在非跳跃组中有 45例 (36 6 % )纵隔淋巴结转移扩至 2或 3个区域 (L2或L3)。跳跃组的 5年生存率为 2 9 3% ,高于非跳跃组(12 .2 % ,P =0 0 38) ,且在同一L1上 ,跳跃组 5年生存率 (32 1% )亦高于非跳跃组 (15 .3% ,P =0 0 42 )。结论 NSCLC患者纵隔淋巴结跳跃性转移为纵隔淋巴结转移病变中独特的一个亚群。
Objective To explore the clinical features and prognosis of mediastinal lymph node skipping and non-hopping metastasis in non-small cell lung cancer (NSCLC). Methods 176 patients with stage IIIA NSCLC with surgical treatment of mediastinal lymph node metastasis from 1982 to 1994 were studied. Among them, 53 patients without hilar lymph node metastasis were referred to as jumping group; 123 patients were associated with lung disease. Portal lymph node metastases are called non-jump groups. The mediastinal lymph nodes were divided into 3 regions and the extent of lymph node metastasis and the relationship between them and survival rate were analyzed. Results In the jump group, 49 cases (92.5%) of mediastinal lymph node metastasis were confined to 1 area (L1), while in the non-hopping group 45 cases (36.6%) of mediastinal lymph node metastasis expanded to 2 or 3 areas. (L2 or L3). The 5-year survival rate of the jump group was 293%, which was higher than that of the non-jump group (12. 2%, P =0 38). On the same L1, the 5-year survival rate (32 1%) of the jump group was also high. In the non-jump group (15. 3%, P =0 0 42). Conclusion The metastasis of mediastinal lymph nodes in NSCLC patients is a unique subpopulation of mediastinal lymph node metastases.