The Analysis Of N₁ Characteristics And Influencing Factors In T₂ Stage NSCLC

Objective Investigating the characteristics and influencing factors of Ni in T2 st-age(the 8th TNM stage of IASLC 3<tumor size≤5cm)non-small cell lung canc-er(NSCLC),on the one hand,to demonstrate the necessity of intrapulmonary lym-ph node dissection in the operation and make clear the sweep range;on the oth-er hand,to find out some high-risk factors that influence the metastasis of lung lymph node,taking more attention to clear the intrapulmonary lymph node for th-ese patients.Methods We had collected the clinical information of patients who underwent th-e surgical treatment in our department from October 2011 to November 2016.Basing on the strict admission and exclusion criterias,68 patients with the non-s mall cell lung cancer were filtered and analyzed retrospectively in T2 stage.It In-cluded 48 males and 20 females at age of 48々81(average 63.1±7.6)years old.Al-1 the research objectives were examined by routine preoperative examination,to exclude metastasis of the distant organs and other malignant tumors.There were no obvious abnormalities of heart and pulmonary function in these patients.All the people had an operation of the ipsilateral lesion resection and mediastinal ly-mph node dissection in the general anesthesia.Meanwhile,We cleared intrapulmon-ary lymph node in the greatest degree.According to the pathological results,all the lymph nodes were classfied and made statistical analysis.Through the descrip tion of the normal distribution data and comparison of the count data,to identify the most common metastatic area and the characteristics of Ni.In the single fact-or analysis,We explored the relationship between the sex of the patients,the path-ological type of the lung cancer,the diameter of tumor,the location of the lesion,the level of CEA and intrapulmonary lymph nodes metastasis with chi-square tes-t and multivariate analysis.Results Sixty-eight patients with lung cancer were enrolled in T2 stage.A total of 1442 thoracic lymph nodes were collected,with an average of(21.2 ± 9.3)pieces every person.124 lymaph nodes showed lymphatic metastasis with a metast-asis degree of 8.6%.We harvested 590 intrapulmonary lymph nodes,accounting for 40.9%of the total lymph nodes.It contained 54 cases of positive lymph no-des,the positive rate is about 9.2%.There were 28 patients with lymphatic metast-asis form the postoperative pathological results,the transfer rate was about41.2%.There were 14 patients of Ni metastasis,9 of N1+N2 and 5 of N2 skippng metast-asis among these patients.The results showed that the highest positive rate of ly-mph node were 12th,13th and 6th groups,which were about 14.8%,14.3%and 13.9%respectively.The lowest positive rate of lymph node were 8th and 14th,the transfer rate were zero.The No.6 and No.5 lymph nodes had a high positive rate,so surgeons should take more attention to clear these areas.The No.2 and No.4 lymph nodes that the surgeons often cleaned areas had a low positive rate,7.7%and 7.8%respectively.They were lower than the total lymph node metastas-is rate(8.6%).In the single factor analysis,it showed that male,age of no more than 63 years,T2b stage,poorly differentiated degree were the risk factors for lung squamous cell carcinoma and adenocarcinoma lung lymph node metastasis(p<0.05).But there was no significant effect between tumor pathology,lesion lo-cation,CEA level and the intrapulmonary lymph nodes metastasis(p>0.05).Mean-while,the intrapulmonary lymph nodes metastasis was no significant correlation with above risk factors according to the multivariate analysis.Conclusion It is necessary to extract the intrapulmonary lymph node of T2 NSC LC at utmost,especially for the No.12 and No.13 high-risk areas,and the sub-lung region is unnecessary to eliminate.In clinical,for the lesion in the left lobe of patients,surgery should strengthen on the regional lymph node dissection of 5th and 6th groups.The 2nd and 4th lymph nodes of right lung cancer can be selectively removed.The esophagus lymph nodes may not be removed.The male,age of no more than 63 years,T2b stage and poorly differentiated degree may be influence factors for the intrapulmonary lymph nodes metastasis of the lung canc-er patients in T2 stage.But they are not the determining factors.