Clinical Research On Lymph Node Metastasis Of Lung Adenocarcinoma With Diameter Less Than2cm

Purpose:This study is about lung adenocarcinoma with diameter less than2cm，weinvestigate the correlation of lymph node metastasis with the site of the tumor, tumorsize,gender, male smoking index, carcino-embryonic antigen(CEA), distant metastasisand the target gene mutations, and analyze the characteristics of mediastinal lymphnode metastasis.Methods:A total of127lung adenocarcinoma cases with diameter less than2cmwere include for a clinical analysis,and VATS lobectomy and systemic lymph nodedissection were performed in all cases.Results: Lymph node metastasis of lung adenocarcinoma was not related to gender,male smoking index,and target gene mutations. The rates of LN metastasis were12.0%,13.5%, and21.5%respectively in d≤1.0cm,1.0cm＜d≤1.5cm,and1.5cm＜d≤2.0cm,while which had no statistically differences (d:diameter of tumor). Caseswith the value of CEA greater than5ug/L were more frequent to have LN metastasisthan those whose CEA were normal (P<0.01).And cases with LN metastasis hadhigher rates of distant metastasis than those who didn’t have LN metastasis in twoyears (P<0.01). N2metastasis occurred in17of the cases.They showed some regionalfeatures according to different site of the tumor.We found the rate of LN metastasis ofthe left lung adenocarcinoma was higher than the right one.Conclusion: Lymph node metastasis of lung adenocarcinoma with diameter less than2cm had nothing to do with gender, male smoking index,and target genemutations,but was closely tied with the value of CEA. Distant metastasis was morecommonly seen in lung adenocarcinoma with LN metastasis than the others in twoyears. Mediastinal lymph node metastasis could occur in lung adenocarcinoma withdiameter less than2cm,and they showed some different regional features with different site of the tumor.All lung adenocarcinoma cases with T1a should undergosystemic lymph node dissection as long as their cardio-pulmonary function werewell-behaved.And we could take some emphasis according to the site of tumor whendissecting the mediastinal lymph nodes.