肺癌伴腋窝淋巴结转移患者临床特点分析

发布时间：2019-02-16 01:52

【摘要】：目的:总结肺癌伴腋窝淋巴结转移(axillary lymph node metastasis,ALNM)的临床特点。方法:回顾性分析2007年1月至2013年12月浙江省肿瘤医院收治的91例肺癌ALNM的患者资料。采用列联表分析原发灶、颈部和锁骨上区淋巴结、纵隔淋巴结与腋窝淋巴结位置相关性,采用Kaplan-Meier法计算总生存,以及不同时期发现ALNM患者的生存情况,并行Log-rank检验,进一步进行Cox回归分析。结果:肺癌伴ALNM发生率为0.63%;常见于腺癌患者,以周围型病灶多见,常累及胸膜并伴胸水,或发生胸壁转移。原发灶、颈部和锁骨上区淋巴结、纵隔淋巴结与腋窝淋巴结位置存在相关性。肺癌伴ALNM的患者中位生存时间为19.02个月,2年生存率为62.64%。首诊伴ALNM患者生存情况差于首诊无腋窝淋巴结患者,且为独立预后因子(P=0.003,RR=2.18,95%CI:1.330~3.572)。结论:肺癌伴ALNM发生率低,其可能的转移途径为胸壁、淋巴引流及血行转移,首诊发现ALNM的患者生存情况更差。
[Abstract]:Objective: to summarize the clinical features of lung cancer with axillary lymph node metastasis (axillary lymph node metastasis,ALNM). Methods: the data of 91 patients with ALNM from January 2007 to December 2013 were analyzed retrospectively. The location of primary lesion, cervical and supraclavian lymph nodes, mediastinal lymph nodes and axillary lymph nodes were analyzed by column tables. The total survival was calculated by Kaplan-Meier method, and the survival status of ALNM patients was found at different stages. Log-rank test was performed. Further Cox regression analysis was performed. Results: the incidence of lung cancer with ALNM was 0.63%. Primary lesions, cervical and supraclavian lymph nodes, mediastinal lymph nodes were correlated with axillary lymph nodes. The median survival time of lung cancer patients with ALNM was 19.02 months and the 2-year survival rate was 62.64 months. The survival condition of the first patient with ALNM was worse than that of the first patient without axillary lymph node, and it was an independent prognostic factor. Conclusion: the incidence of lung cancer with ALNM is low, and the possible way of metastasis is chest wall, lymphatic drainage and blood metastasis.
【作者单位】：浙江省肿瘤医院浙江省胸部肿瘤重点实验室;
【分类号】：R734.2

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