Glandorf Julian, Vogel-Claussen Jens
Institut für Diagnostische und Interventionelle Radiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
Radiologie (Heidelb). 2023 Mar;63(3):187-194. doi: 10.1007/s00117-022-01102-7. Epub 2023 Jan 2.
Lung cancer has enormous socioeconomical impact on our society due to its high prevalence and mortality. About 59,700 new cases of lung cancer were forecasted for 2022.
Correct staging is the basis for therapy planning, prognosis estimation, and future analyses. Staging is performed using the TNM scheme from the Union for International Cancer Control (UICC). Involvement of lymph nodes is used to differentiate between stage IIB and IIIC.
Knowledge of the intrathoracic lymph node levels is crucial for the exact classification and its involvement has direct implications on therapy. The International Association for the Study of Lung Cancer (IASLC) proposed a unified lymph node map with exact anatomic definitions, which is recommended by the German national lung cancer guideline. The extent of lymph node involvement is stratified into N0-N3. Different metastatic paths are known depending on the location of the primary tumor, but the burden of disease has a greater influence on survival, than the location of metastases.
Computed tomography can assess operability of the primary tumor safely in most cases. Invasive procedures to confirm the diagnosis by sampling tissue should be performed after noninvasive diagnostics.
Systematic lymph node dissection for all patients with non-small cell lung cancer intended for curative resection is recommended in the current German national guideline for lung cancer.
由于其高发病率和死亡率，肺癌对我们的社会产生了巨大的社会经济影响。预计2022年将有大约59,700例新发肺癌病例。
TNM分期方案：正确分期是治疗计划、预后评估和未来分析的基础。分期采用国际癌症控制联盟（UICC）的TNM方案进行。淋巴结受累情况用于区分IIB期和IIIC期。
了解胸内淋巴结分区对于准确分类至关重要，其受累情况对治疗有直接影响。国际肺癌研究协会（IASLC）提出了具有精确解剖定义的统一淋巴结图谱，德国国家肺癌指南推荐使用该图谱。淋巴结受累程度分为N0 - N3。根据原发肿瘤的位置，已知不同的转移途径，但疾病负担对生存的影响大于转移部位。
计算机断层扫描在大多数情况下能够安全地评估原发肿瘤的可切除性。在进行非侵入性诊断后，应通过组织采样进行侵入性操作以确诊。
在当前德国国家肺癌指南中，建议对所有拟行根治性切除的非小细胞肺癌患者进行系统性淋巴结清扫。
