Clinical Study of Lymph Nodes Metastasis and Dissection of 434 Cases of Lung Cancer

To study the lymph nodes metastasis of lung cancer and to find reso-nable dissection of lymph nodes Methods In 434 surgical patients with lung cancer, the pathologically confirmed dissected lymph nodes were retrospectively analyzed. Results Among 2 198 groups of lymph nodes systemically dissected, 749 groups were pathologically metastative. The rate of lymph nodes metastasis for T1 was 16. 5% ,T2 33. 5% , T3 35. 6%, T4 52. 3% ;T1 and T4 had significantly lower and higher metastasis rates respectively. The metastasis rate of lymph nodes in the upper mediastinum of upper lobe cancer was significantly higher than that in the lower mediastinum. Aortic lymph node metastasis was found in left upper lobe cancer in 37 out of 121 patients, while subcarinal lymph node metastasis was in both lower lobe and right middle lobe cancers in 48 out of 181 patients. Conclusion Lymph node metastasis is limited to regional upper or lower mediastinal area in T1 lung cancer, while both upper and lower mediastinum are metastasis sites for both lower lobe cancers. Aortic and subcarinal lymph node metastases are the signals for diffusion of lymph node metastasis between upper and lower mediastinum. Systemic dissection of lymph nodes should be done in all lung cancers except that regional mediastinal dissection is enough in T1 lung cancer.