金良 于庆凯 刘先本 吉庆明 高宗人 龙志强 乔思杰 450003 郑州，河南省肿瘤医院胸外科(许金良、刘先本、高宗人、龙志强)，病理科(于庆凯、吉庆明、乔思杰) 中华肿瘤杂志 1998 11 0 6


    关键词：肺肿瘤/外科学；侵袭/病理学；肺切除术；肿瘤侵袭 期刊 zhzlzz 0 临床研究 fur -->


    

【摘要】 目的 探讨不同组织类型肺癌向近端支气管壁侵袭的规律。方法 对151例中心型肺癌手术切除标本近端支气管进行不同断面的病理学研究。其中，全肺切除标本41例，肺叶切除标本110例。结果 癌细胞沿管壁粘膜下层或多层面直接侵袭是癌扩延的主要方式，96.6%的癌侵袭发生在距瘤缘1.5cm以内的管壁上。其侵袭距离与病理类型、侵袭方式及TNM分期因子(pT、pN)相关。转移淋巴结对管壁的侵袭也是癌扩延不容忽视的形式。结论 为获得根治切除，支气管切端距瘤缘的安全界限原则上应超过1.5cm，并须彻底清除肺门纵隔淋巴结。

Proximal bronchial invasionof lung cancer: a clinicopathological study Xu Jinliang, Yu Qingkai, Liu Xianben, et al. Henan CancerHospital, Zhengzhou 450003

    【 Abstract】 Objective To investigate the characteristics of proximal bronchialinvasion of lung cancer of different types. Methods Proximal bronchus of 151 operatively resected specimens ofhilar type lung cancer was selected for cross-sectional pathological study. Forty onespecimens were obtained from total pulmonectomy, and 110 from pulmonary lobectomy. Results Evidence showed that thedirect invasion of tumour cells through the submucosal layer or multiple layers was themajor form of lung cancer spread; 96.6% of the cancerous invasion occurred at the proximalbronchial wall less than 1.5 cm apart from the margin of the cancer. The extension ofinvasion was correlated with the histopathologic type of cancer, mode of invasion and TNM classification(pT, pN). Besides, the invasion in the bronchial wall by metastatic lymphnodes was also an important way for the cancer spread. Conclusion In order to achieveradical removal of tumor, it is imperative to keep a distance of 1.5 cm or more betweenthe excision margin of the bronchus and the tumor, and to completely resect the hilar andmediastinal lymph nodes.

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