| Objectives: To investigate the effects of thoracoscopic lobectomy and systemic lymphadenectomy on non-small cell lung cancer(NSCLC)with tumor diameter ? 3cm in intraoperative or postoperative pathological specimens,In our hospital thoracic surgery.(N),and to describe the lymph node metastasis rate of non-small cell lung cancer(NSCLC)with diameter ? 3cm,Simultaneously,to evaluate the relationship between tumor location,tumor location,tumor size(d),tumor pathological type and differentiation grade,tumor markers(CEA,NSE,CYFRA21-1)and lymph node metastasis,as well as to analyze the clinical law of lymph node metastasis,explore the diameter of ? 3cm non-small cell lung cancer lymph node metastasis and the relevant influencing factors,these studies can help patients with early NSCLC in the clinical treatment options to provide a reference Advice,and choose the most beneficial treatment for it.Methods: 169 patients with NSCLC with diameter ? 3 cm were treated with thoracoscopic lobectomy and systemic lymphadenectomy from June 2000 to December 2016 by thoracic surgery from Dalian Medical University.The clinical data of these patients were retrospectively analyzed,Tumor-related pathophysiological factors were selected according to whether the patients had lymph node metastasis,the related pathophysiological factors such as tumor location,tumor size,tumor pathologic type and differentiation grade,tumor markers(CEA,NSE,CYFRA21-1),etc for correlation analysis,and so on to find out the statistically significant factors influencing the metastasis of NSCLC with diameter ? 3cm,and to explore the significance of the results in clinical treatment.Results: Of the 169 cases,27 cases had lymph node metastasis.The overall metastasis rate was 16.0%.Among them,only 3 cases had lymph node metastasis from group 2 to group 9,There was ipsilateral lymph node metastasis,there have been contralateral lymph node metastasis,that is,cross-transfer.At the same time,we found that there was no correlation between the lymph node metastasis and the location of the primary tumor(P = 0.179 and P = 0.780,respectively)for the diameter of ?3 cm NSCLC.The lymph node metastasis rates of tumor diameter d?1.5cm and 1.5cm <d?3.0cm were9.7% and 23.7%,respectively,and the results were statistically significant(P <0.05).CEA ? 5ug /ml,CYFRA21-1? 3.5ug / ml,NSE ? 16.3ug /ml in patients with diameter? 3cm NSCLC more than three values in the normal range of patients more prone to lymph node metastasis(P <0.05).The degree of differentiation of adenocarcinoma was significantly different from that of lymph node metastasis(P <0.05),but there was no significant difference between the degree of differentiation and lymph node metastasis.Conclusion: According to our study,we found that the degree of differentiation of squamous cell carcinoma and primary tumor location were not related to lymph node metastasis,and the tumor markers CEA,CYFRA21-1,NSE,tumor diameter,adenocarcinoma were closely related to lymph node metastasis.CEA ? 5ug / L,CYFRA21-1 ? 3.5ug /ml,NSE ? 16.3ug / ml,diameter ? 3cm NSCLC patients were more likely to develop lymph node metastasis(P <0.05)than the three values Patients in the normal range.And NSCLC patients with tumor diameter at 1.5cm <d?3.0cm appear to be more prone to lymph node metastasis.These findings suggest that,in clinical work,if the tumor volume of NSCLC patients is large,the relevant tumor markers beyond the normal range,especially preoperative biopsy or intraoperative rapid frozen sections found to be poorly differentiated adenocarcinoma,To be alert to lymph node metastasis,intraoperative lymph node dissection should be careful,as far as possible thoroughly clean the hilum,lobe and mediastinal lymph nodes,in order to minimize the probability of postoperative metastasis,and contribute to the clinical correct T stage And to guide the comprehensive treatment after surgery. |
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