| 1. Background and purpose:The incidence and mortality of lung cancer are rising in recent years,and lung cancer has become one of the diseases which have the seriousharm to human health. Lung cancer originates from the bronchialepithelium, and the tumor can grow to the bronchial cavity or lung tissuenearby. The tumor can spread through the lymphatic, blood and bronchialways. According to the report, the non-small cell cancer is about84%.Lung cancer lymph node metastasis is one of the most common ways.The cancer cells invade into adjacent lung segment and lymph nodesaround the bronchus first through the way of the lymphatic channels ofbronchus and vessels. Then cancer cells reach the hilar or subcarinallymph nodes according to the site of cancer, and they can also invade intothe mediastinal and bronchial lymph nodes. Finally the supraclavicularand neck lymph nodes are involved. The lymph node metastasis generallyoccurs in the same side, but it also can occur in the opposite side whenthe invasion of the chest walls and diaphragm, because it may apply tothe underarm lymph nodes or adjacent abdominal aortic lymph nodemetastases. According to the literature currently mediastinal cancerlymph node metastasis rate of30-40%, if the detection of lymph nodemicrometastases in the mediastinal lymph node metastasis rate will behigher, so intraoperative mediastinal lymph node dissection has basically been reached.So the research for the regularity of lymph node metastasisis very important. And it can improve the effect of radical surgery andreduce the recurrence, and it also could prolong survival of postoperative.According to the situation of the primary tumor, lymph nodemetastasis and distant metastasis of tumor staging, Union InternationalCancer Control (UICC) had formulated the lung cancer TNM staging.And they have formulated T staging the new grading in2009. And theyalso carried out on tumor size classification according to the tumor withmaximum tumor diameter (d). They regard d≤2cm as T1a，2cm＜d≤3cmas T1b，3cm＜d≤5cm as T2a，5cm＜d≤7cm as T2b，d＞7cm as T3.The aim of this study is to investigate the relationship between the Tstaging and lymph node metastasis of lung cancer. Then the results willhelp us learn the regulation of lymph node metastasis，and provideguidance for the surgery and follow-up treatment.2. Methods:We have chosen201patients who was non-small cell cancer patients,and they had been prepared for lobectomy. Their clinical date, themaximum diameter of the primary tumor size and lymph node metastasiswere analyzed retrospectively. then we can find the relationship betweentumor size and lymph node metastasis. Analyze the collected data withSPSS software finally. 3. Results:80patients had lymph node metastasis in201cases, and the rate is39.80%.3268lymph nodes were removed in total, and379nodes wereproved to be metastasis, so the lymph node metastasis rate was11.60%.1373N1lymph nodes were removed in total, and184nodes were provedto be metastasis, so the N1lymph node metastasis rate was13.40%. And1895N2lymph nodes removed in total,379nodes were proved to bemetastasis,the rate was10.29%.And the lymph node metastasis rate ofT1a,T1b,T2a,T2b,T3were17.54%,41.82%,45.10%,66.67%,50.00%.there were14cases of d≤1cm，and2of them was lymph node metastasis,the rate was14.28%. Compared with T1b、T2a、T2b and T3,the lymphnode metastatic rate of T1a was significantly different, respectively, andp<0.05. And also there were differences between T1b and T2b. The restswere not different. On N1lymph node metastasis rate, there weresignificant differences between T1a and other ones except T3. On N2lymph node metastasis rate, the result was the same.4. Conclusions:In order to evaluate patient prognosis and guide the next treatment,the mediastinal lymph node dissection is necessary. And the tumor size ispositively correlated with lymph node metastasis, especially in N2lymphnodes. The T1a lymph node metastasis rate is lowest. There issignificantly different in lymph node metastasis rate between T1a andT1b. |
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