| Objective:Operation is the mostly instrument of therapy of non-small cell lung cancer, and it is also the only instrument to cure cancer drastically. The tumor size and the situation of lymph metastasis are the main decisive factors of TNM. It's about not only prognosis but also TNM that whether removal drastically or not. Up to now, the relationship between tumor size and location of the non-small cell lung cancer and lymph metastasis remains controversial. The objective of the current study is to assess the relationship at the time of diagnosis in non-small cell lung cancer by study the 240 cases of had non-small cell lung cancer that required complete surgical therapy.Materials and Methods:A total of 376 non-small cell lung cancer cases were include in the current study. These patients were surgically treated in Tumor Hospital of Jilin Province between January 2008 and December 2008. Their medical records were reviewed and the clinicopathologic characteristics were retrospectively analysis. 120 cases were excluded because the disease stage or tumor diameter were not clear or had received chemoradiotherapy. The tumor size was divided into five groups based on the IUCC/AJCC 2009: Group one(≤2cm), Group two(>2,≤3cm), Group three(>3,≤5cm), Group four(>5,≤7cm), Group five(>7cm). The tumor location was divided into five groups based on the IUCC/AJCC 2009: Group one(LU), Group two(LD), Group three(RU), Group four(RM), Group five(RD). The independent effect of tumor size on the disease stage was analyzed using a logistic regression model. All the analysis were conducted using SPSS17.0 P values less than 0.05 was considered statistically significant.Result:A total of 240 patients, 80 women(33.3% )and 160 men(66.7%), with primary non-small cell lung cancer were included in the final analysis. The mean age(±standard deviation) was 57.7±9.5 years. The mean tumor size(±standard deviation) was 4.01±1.65cm. The distribution of tumor locations: 92 patients (38.3%) in the left lung, 148 patients (61.7%) in the right lung, 114 patients (47.5%) in the upper lung, 29 patients (12.1%) in the middle lung, 97 patients (40.4%) in the under lung. Analysis revealed that there are no associations between sex, location of lung cancer.①Left upper lobe cancer prone aortic area (group5, group6) into the lymph node metastasis, Has emerged in the chest lymph nodes (N1 and (or) N2 positive) cases, 57.14%(12/21).②Right upper lobe cancer-prone Group 4 lymph node metastasis, in the event of intrathoracic lymph node cases, accounting for 66.67%(16/24).③Left lower lobe and right lower lung cancer are prone to lymph node metastasis of group7, in the event of intrathoracic lymph node metastasis cases, respectively, 62.5% (10/16), 72.22% (13/18). Univariate analysis revealed that tumor size affected lymph metastasis. Different tumor size and lymph node metastasis of intrathoracic relationship among the three groups, the difference was not statistically significant. Then①+②and③+④+⑤divided into two sets of analysis, A and B. That is group A of lesion diameter was less than or equal 3cm, group B of lesion diameter was greater than 3cm. In which group A of 93 patients, the incidence of lymph node metastases (N1+N2) % was: 31/93 = 33.33%. In which group B of 147 cases, the incidence of lymph node metastases (N1 + N2)% was: 68/147 = 46.26%; calculated p was less than 0.01. However, further each of 2cm, 5cm, 7cm, as critical value of the maximum diameter of the lesion group), calculated p value was greater than 0.05. Adeno-squamous cell carcinoma was also found that the rate of metastasis N2 was more than squamous cell carcinoma and other types of primary non-small cell lung cancer.Conclusion:The study demonstrated that when the tumor size is grater than 3cm the probability of lymph metastas (N1+N2)is superior to that the the tumor size is equal or lesser than 3cm. However, it isn't that the bigger the tumor was, the more likely lymph metastasis was happened. There are also have relationship between the tumor location and lymph metastasis of N2: different tumor location, differernt position of the lumph metastasis of non-small cell lung cancer. |
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