| ObjectiveThe clinical staging,pathological classification,location of mediastinal lymph node,mediastinal lymph node size and TCM syndrome differentiation of mediastinal lymph nodes in patients with 110 non-small cell lung cancer(NSCLC)were obtained.On the basis of this,the clinical staging,pathological classification and longitudinal differentiation of TCM syndrome and mediastinal lymph nodes were carried out.To explore the correlation between the pathological features of the mediastinal lymph node biopsy and the TCM syndrome type of non-small cell lung cancer,so as to provide new diagnosis and treatment for the diagnosis and treatment of lung cancer,especially in the early non small cell lung cancer.MethodsThe clinical staging and pathological classification of the mediastinal lymph nodes in the First Affiliated Hospital of Guangzhou University of Chinese Medicine were collected from September 19,2014 to January 15,2018 at the First Affiliated Hospital of Guangzhou University of Chinese Medicine(endobronchial ultrasound-transbronchial needle aspiration,EBUS-TBNA).The data of the mediastinal lymph node metastasis and the mediastinal lymph nodes were collected,and the data were collected by SPSS 19 statistical software.On this basis,the correlation between the pathological features of the mediastinal lymph node biopsy and the TCM syndrome type of non-small cell lung cancer was discussed.Results1、110 cases of EBUS-TBNA examined and untreated NSCLC mediastinal lymph node pathological features,squamous cell carcinoma and adenocarcinoma were the most common pathological types of NSCLC patients,which accounted for 71.82% and 26.23% respectively.The total number of patients in stage I and II was only 5 cases,mainly in stage III and IV,accounting for 30.91% and 64.55% respectively.T stage accounted for 40% of T4 stage,followed by T2 stage 23.64%.There were 6 cases of 3,8 and 9 groups of mediastinal lymph nodes.The mediastinal lymph node metastases were mainly concentrated in 4,5 and 7 mediastinal lymph nodes,accounting for 39.34%,5.74% and 50%,respectively.The length of mediastinal lymph nodes is more common in 1-3cm.2、110 cases of NSCLC patients’ clinical stage pathological classification and TCM syndrome type correlation,III phase,IV phase of TCM syndrome distribution comparison,there is statistical difference(P<0.05).In III phase,the syndrome of phlegm and heat resistance was more common,accounting for 47.06%,the deficiency of lung and Spleen Qi was 23.53%.In the IV period,29.58% of the lung spleen qi deficiency syndrome and qi stagnation and blood stasis syndrome were all,and 21.13% of the phlegm and heat resistance lung syndrome.The TCM syndrome type of non-small cell lung cancer accounted for 29.09% of phlegm and heat resistance syndrome,followed by lung qi deficiency syndrome(28.18%),qi stagnation and blood stasis syndrome(26.36%),Qi Yin deficiency syndrome(10.91%)and lung yin deficiency syndrome(5.45%).There was no statistical difference in TCM syndromes between different T stages.T stage was most common in T2 stage,32.73%,followed by T4 stage 30.91%.There was no difference in TCM syndromes between T staging patients.In the classification of pathological tissue,31.03% of squamous cell carcinoma were sputum heat resistance syndrome,followed by qi deficiency syndrome and qi stagnation and blood stasis syndrome;adenocarcinoma with lung spleen qi deficiency syndrome accounted for 29.11%,followed by qi stagnation and blood stasis syndrome and phlegm heat resistance lung syndrome,different pathological histological type and TCM Syndrome type had no significant difference.3、There was no significant difference in pathological features between mediastinal lymph nodes and clinical stages of NSCLC patients.The mediastinal lymph node metastasis sites were mainly in 4 groups,5 groups and 7 groups of lymph nodes,and 3,8 and 9 groups had fewer lymph nodes.Lymph node metastasis in 4 groups,5 groups and 7 groups was more common in stage IV patients,accounting for 62.50%,85.71% and 60.66% respectively.The 4 groups of lymph nodes were mostly distributed in T2 stage,accounting for 25%;5 groups of lymph nodes were mostly distributed in T2 stage,57.14%;7 group lymph nodes were more common in T4 stage,accounting for 44.26%.The length of mediastinal lymph nodes in 110 patients was more common in 11-20 mm and 21-30 mm,accounting for 32 cases and 25 cases respectively.There was no significant difference in mediastinal lymph node size and clinical stage typing between NSCLC patients.4、The correlation between the pathological features of the mediastinal lymph nodes and the syndrome type of NSCLC,the 4 groups of lymph nodes with qi stagnation and blood stasis are the most common in the 4 groups of lymph node metastases,accounting for 39.58%,followed by the deficiency of spleen qi deficiency syndrome and phlegm heat resistance,accounting for 20.83%.The 5 groups were mostly lung and spleen qi deficiency syndrome and qi stagnation and blood stasis syndrome,accounting for 28.57%.The 7 groups of lymph nodes were mostly lung and spleen deficiency syndrome,accounting for 29.82%,followed by phlegm heat obstructing lung syndrome and qi stagnation and blood stasis syndrome,accounting for 28.07% and 26.32% respectively.There was no significant difference in mediastinal lymph node metastasis and TCM Syndrome Types in each group.The mediastinal lymph node size,the median of the mediastinal lymph node length of the lung spleen qi deficiency syndrome is 27 mm,the median of the long diameter of the mediastinal lymph node of the lung yin deficiency syndrome is 25 mm,the long diameter of the mediastinal lymph node in the Qi Yin two deficiency syndrome is 26 mm,the long diameter of the mediastinal lymph node of qi stagnation and blood stasis syndrome is 24 mm,the length of the lymph node in the mediastinum of the phlegm heat resistance lung syndrome is 18.50 mm,and the longitudinal of the TCM syndrome type is the longitudinal diameter of the syndrome.The difference in the size of the septum was not statistically significant.ConclusionThe combination of traditional Chinese and Western medicine is the characteristic of the treatment of NSCLC in China.In the course of NSCLC treatment,the combination of traditional Chinese medicine theory and modern medicine,the rational application of the existing treatment methods,the improvement of the clinical symptoms,the improvement of the quality of life,the stability of the focus,the prolonged survival period,has a broad application value.This study shows that squamous cell carcinoma and adenocarcinoma are the most common pathological types of NSCLC patients,and NSCLC is common in phase III and IV.T stage is common in T2 phase and T4 phase.Mediastinal lymph node metastases were mainly located in mediastinal lymph nodes of 4 groups,5 groups and 7 groups.The length of mediastinal lymph nodes was more common in 1-3cm.There is a certain relationship between the TCM syndrome type and the TNM staging.To a certain extent,the clinical feasibility of the theory of "there must be all outside" is verified,which provides a certain reference for the clinical syndrome differentiation and treatment. |
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