Analysis in lymph node metastasis of non-small cell lung cancer

Background and purpose:Lung cancer lymph node metastasis is the most common metastatic pathways that affect staging and prognosis.Intrathoracic lymph node metastasis including hilus and mediastinum is one of important prognosis factors of lung cancer.The aim of this study was to analyze the characteristics of lymph node metastasis in non-small cell lung cancer(NSCLC) and to provide evidence for determining the range of lymph node dissection.Methods:Two hundred and five NSCLC patients underwent surgery were enrolled.Intrathoracic lymph nodes were compared in each group the frequency.Besides from the primary tumor site and pathological type point of view,lymph node metastasis rates and skip metastasis rates differences were compared.Results:Two hundred and five NSCLC patients with intrathoracic lymph node dissection in 977 lymph node groups,a total number of 3 577 lymph nodes,with an average of 17.4.Metastasis occurred in 220 groups,508 lymph nodes,and were all confirmed by pathological methods.Intrathoracic lymph node metastasis occurred in 98 patients,the transfer rate was 47.8%.Skip metastasis occurred in 35 cases,the transfer rate was 17.1%.The 4,5,7,10,11 groups had a higher frequency of lymph node metastasis.Compared with the next(middle) lobe,skip metastases occurred more likely in upper lobe lung cancer.In adenocarcinoma,lymph node metastasis was significantly higher than squamous cell carcinoma.Conclusion:The major mediastinal transfer of NSCLC is metastasizing between pulmonary lymph nodes and then to mediastinal lymph nodes in sequential order,which was usually occured to mediastinal lymph node directly.The transfer is closely related to the primary tumor site and type.The lymph node dissection should be based on the rule of intrathoracic lymph node metastasis.Doctors should pay more attention to the 4,5,7,10,11 group lymph nodes which are transferred frequently.