| Objectives:1.Observed the isolated lung malignant vitrified Ni,N2 lymph node metastasis.2.To explore the influencing factors and cleaning methods of lymph node metastasis of isolated malignant ground glass.Methods:A total of 120 patients with isolated isolated malignant vitrified pure glass were treated during the period from February 2017 to February 2018 in the Department of Thoracic Surgery,the Third Affiliated Hospital of Kunming Medical University.The general data of 120 patients were collected.The patient’s age,sex,pathological type,maximum diameter of the tumor,the number of lymph nodes that were dissected,and the metastasis of N1,N2.A wedge resection was performed under VATS or TTS,and frozen during the procedure.If the result of the freezing suggests malignant,lobectomy + systemic lymph node dissection(SLND)(N1,N2)was performed.Lymph nodes N1(10-14 group lymph nodes were taken out as group)and N2(left lung lobes:4-9 group lymph nodes were taken out as group;right lung lobes were 2-4 groups,7-9 group lymph nodes were taken out as group)were grouped Send a medical examination and record the lymph node metastasis of the patient.All data were statistically analyzed using spss22.0.The comparison of rates was performed using chi-square test.P<0.05 was considered statistically significant.Results:The total number of lymph nodes in the whole group was 2264,and each patient had an average of 18.9 lymph nodes.Among them,30 lymph nodes were metastasized and the metastasis rate was 1.33%.General pathological examination of 113 patients did not show N1 and N2 lymph node metastasis.5 patients with isolated Ni lymph node metastasis were found to have a detection rate of 4.17%.N1 and N2 lymph node metastases were detected in 2 patient and the detection rate was 1.67%.In the case of solitary isolated ground glass in the lungs,no lymph node metastasis was detected when the maximum diameter was ≤ 1 cm,and N1 and/or N2 lymph node metastasis could occur when the maximum diameter was>1 cm.Of the 7 patients with lymph node metastases,4 patients with lymph node metastases in group 12 and/or 13 and/or 14 were present.The lymph node metastasis rate in the 12th to 14th groups in the removed lungs was 2.60%,reflecting the normal pathological examination.The rate of lymph node metastasis in the 2nd to 11th groups was 0.56%,showing the difference was statistically significant.Among patients with lymph node metastasis,the difference between the lymph node metastasis rate of 3.14%in patients with squamous cell carcinoma and the lymph node metastasis rate of 1.19%in patients with adenocarcinoma was statistically significant(P<0.05).Conclusions:1.The isolated malignant malignant ground-glass lymph node metastasis is related to the maximum diameter and pathological type of the tumor.2.When the maximum diameter of the isolated malignant vitrified image of the lungs is ≤ 1cm,lymph node metastasis rarely occurs,It is recommended that no lymphadenectomy or lymph node sampling be performed;When the isolated malignant vitreous opacities of the lungs have a maximum diameter of>1 cm,systemic lymph node dissection is recommended.3.For patients with isolated malignant malignant purely ground glass tumors with a maximum diameter of>1 cm,it is recommended that conventional mediastinal lymph node dissection be performed while cleaning up the 12 to 14 groups of lymph nodes in the lungs.This may help to detect potential lymph node metastases in patients with false negatives.Postoperative staging and postoperative adjuvant therapy have important guiding roles. |
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