Usuda K, Saito Y, Kanma K, Sagawa M, Sato M, Nagamoto N, Fujimura S
Department of Surgery, Tohoku University, Sendai, Japan.
Nihon Geka Gakkai Zasshi. 1993 Jun;94(6):631-6.
The relationship between tumor size and nodal involvement of resected roentgenographically occult squamous cell carcinoma in 127 cases was documented. Survival and recurrent patterns were analyzed. Intrabronchial invasion was observed in 103 cases and extrabronchial invasion in 24 cases. One hundred and nineteen cases (94%) had N0 diseases, six (5%) N1 diseases and two (2%) N2 diseases. One hundred and one cases were in early stage and 26 in non-early stage. Nodal involvement was observed in two (2%) of the 103 cases with intrabronchial invasion and in six (25%) of the 24 cases with extrabronchial invasion. Nodal involvement was noted in none (0%) of 55 cases in whom longitudinal extension of tumors was within 10mm, but was noted in four (9%) of 46 cases in whom it was 11 to 20mm and in four (15%) of 26 cases in whom it was 21 to 55mm. Death from primary lung cancer occurred in three (12%) of the non-early cases, but in none (0%) of the early cases. Death from multiple metachronous lung cancer occurred in one (4%) of the non-early cases and in three (3%) of the early cases. Nodal and extrabronchial involvement reduced survival. Recurrence often involved hilar, mediastinal, supraclavicular nodes, and surgical margin of bronchus.
记录了127例经影像学检查隐匿的切除性鳞状细胞癌的肿瘤大小与淋巴结受累之间的关系。分析了生存和复发模式。观察到103例有支气管内侵犯，24例有支气管外侵犯。119例（94%）为N0期疾病，6例（5%）为N1期疾病，2例（2%）为N2期疾病。101例处于早期，26例处于非早期。在103例有支气管内侵犯的病例中有2例（2%）出现淋巴结受累，在24例有支气管外侵犯的病例中有6例（25%）出现淋巴结受累。在肿瘤纵向延伸在10mm以内的55例病例中无一例（0%）出现淋巴结受累，但在肿瘤纵向延伸为11至20mm的46例病例中有4例（9%）出现淋巴结受累，在肿瘤纵向延伸为21至55mm的26例病例中有4例（15%）出现淋巴结受累。非早期病例中有3例（12%）死于原发性肺癌，但早期病例中无一例（0%）死于原发性肺癌。非早期病例中有1例（4%）死于多灶性肺癌，早期病例中有3例（3%）死于多灶性肺癌。淋巴结和支气管外受累降低了生存率。复发常累及肺门、纵隔、锁骨上淋巴结以及支气管手术切缘。
