非小細(xì)胞肺癌肺內(nèi)淋巴結(jié)規(guī)范化清掃的臨床研究(附234例報(bào)告)
[Abstract]:Background and objective standardized lymph node dissection in (NSCLC) resection of non-small cell lung cancer is of great significance. According to the recommendation of UICC and AJCC, NSCLC lymph nodes can be divided into the first station (N1) and the second station (N2). The first stage lymph nodes include hilar (No10), interlobar (No11), paratobronchial (No12), segmental bronchus (No13) and subsegmental bronchus (No14). The 13th and 14th groups of lymph nodes are also known as intrapulmonary lymph nodes (Intrapulmonary lymph node,ILN). In clinical practice, insufficient attention has been paid to the cleaning and examination of ILN. The purpose of this study was to study the clinical value of standardized intrapulmonary lymph node dissection in NSCLC resection. Methods from January 2013 to December 2015, 234 patients with primary peripheral NSCLC underwent radical resection in the same operation group, the first affiliated Hospital of Chongqing Medical University. After pneumonectomy, the patients were dissected along the bronchial tree, the lymph nodes (i.e. No12,No13,No14) in the related areas were cut off one by one, stored in bags and marked for pathological examination. The mediastinal lymph nodes were systematically cleaned at the same time during the operation. Results A total of 3019 N1 lymph nodes were removed, with an average of 12.90 lymph nodes per case, of which 263 were metastases, the metastasis rate was 8.71%. There were 11 patients (4.70%) with jump N2 metastasis. 135 cases (57.69%) had no N _ 2 and N _ 1 lymph node metastasis by routine pathology. Among the 16 patients with lymph node metastasis in group 13 or / and group 14, the positive rates of No10,No11,No12,No13,No14 lymph node metastasis were 2.69%, 10.51%, 9.83%, 10.43% and 8.48%, respectively. The missed diagnosis rate of No13 and No14,N1 without cleaning was 6.84% (16 / 234). Conclusion the standard cleaning of intraoperative pulmonary lymph nodes is helpful to detect the possible missed diagnosis of lymph node metastasis, which will be of great significance for the accurate staging of primary NSCLC and the choice of postoperative adjuvant treatment.
【學(xué)位授予單位】:重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2017
【分類(lèi)號(hào)】:R734.2
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