隆突下区肺癌中 N1 和 N2 淋巴结描述符之间的边界：简要报告。

Boundary between N1 and N2 Lymph Node Descriptors in the Subcarinal Zone in Lower Lobe Lung Cancer: A Brief Report.

机构信息

Division of Thoracic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.

Division of General Thoracic Surgery, Kyorin University School of Medicine, Tokyo, Japan.

出版信息

J Thorac Oncol. 2016 Jul;11(7):1176-80. doi: 10.1016/j.jtho.2016.03.014. Epub 2016 Apr 4.

DOI:10.1016/j.jtho.2016.03.014

PMID:27058910

Abstract

INTRODUCTION

In the International Association for the Study of Lung Cancer (IASLC) lymph node (LN) map, some LNs in the subcarinal space defined as #10 (N1) in the Naruke map were changed to #7 (N2). We aimed to validate the boundary between N1 and N2 in the subcarinal zone.

METHODS

We reviewed the records of 399 consecutive patients who had undergone complete resection for lower lobe non-small cell lung cancer. Involved lymph node stations were classified as N1 by both maps (N1 group), N1 by the Naruke map but reclassified as N2 by the IASLC map (#10 [subcarinal] group), and N2 by both maps (N2 group). The survival rates among these groups were compared using Kaplan-Meier and log-rank analyses.

RESULTS

LNs were classified as N0, N1, and N2 in 268, 67, and 64 patients, respectively, on the IASLC map and as N1 and N2 in 82 and 49 patients, respectively, on the Naruke map. The 5-year disease-free survival rates were 81.7% for N0, 50.9% for N1, 33.3% for the #10 (subcarinal) group, and 24.4% for N2. The rates of the N1 and #10 (subcarinal) groups were significantly different (p = 0.027), but those of the N2 and #10 (subcarinal) groups were not (p = 0.78). On multivariate analysis, metastatic disease in the LNs of #10 in the subcarinal space was an independent prognostic factor for patients classified as N1 on the Naruke map (hazard ratio = 2.47, 95% confidence interval: 1.17-4.85, p = 0.019).

CONCLUSION

All lymph nodes in the subcarinal space should be defined as #7 (N2) for prognosis.

摘要

介绍

在国际肺癌研究协会（IASLC）淋巴结（LN）图谱中，Naruke 图谱中定义为#10（N1）的隆突下空间中的一些 LN 被改为#7（N2）。我们旨在验证隆突下区域 N1 和 N2 之间的边界。

方法

我们回顾了 399 例接受下叶非小细胞肺癌完全切除术的连续患者的记录。根据两种图谱，将受累淋巴结站分类为 N1（N1 组）、Naruke 图谱为 N1 但 IASLC 图谱重新分类为 N2（#10 [隆突下]组）和两种图谱均为 N2（N2 组）。使用 Kaplan-Meier 和对数秩分析比较这些组之间的生存率。

结果

IASLC 图谱上，分别有 268、67 和 64 例患者的淋巴结分类为 N0、N1 和 N2，Naruke 图谱上分别为 N1 和 N2，分别为 82 和 49 例。N0 的 5 年无病生存率为 81.7%，N1 为 50.9%，#10（隆突下）组为 33.3%，N2 为 24.4%。N1 和#10（隆突下）组的比率有显著差异（p=0.027），但 N2 和#10（隆突下）组的比率无显著差异（p=0.78）。多因素分析显示，隆突下空间#10 淋巴结转移是 Naruke 图谱上分类为 N1 的患者的独立预后因素（风险比=2.47，95%置信区间：1.17-4.85，p=0.019）。