| Objective To analyze characteristics and related factors of subcarinal lymph nodes metastasis in non-small cell lung cancer patients.Methods Clinical and pathological data of 282 patients with NSCLC who were subjected to complete resection of the tumor together with systematic mediastinal lymphadenectomy in The First Affiliated Hospital of Nanjing Medical University from January 2013 to June 2014,were retrospectively researched by univariate analysis and multivariable logistic regression analysis.Results Subcarinal lymph nodes metastasis was found in 27 of 282 patients,the rate was 9.5%.Tumor size,tumor location,pathological type,involving the visceral pleura,positive hilum lymph nodes and interlobar lymph nodes were correlated with subcarinal lymph nodes metastasis.The rate of subcarinal lymph nodes metastasis was lower in upper lobe lung cancer,the lowest was right upper lobe(1.19%),next was left upper lobe(9.23%),right middle lobe(13.64%),left lower lobe(14.81%),right lower lobe(15.79%).Patients with different tumor size had significantly different subcarinal lymph nodes metastasis rates,≤2cm group 1.11%,2-3cm group 9.86%,3-7cm group 16.30%,>7cm group 13.79%.Adenocarcinoma metastasizing to subcarinal lymph nodes was easier than squamous carcinoma(12.57% vs 2.60%).But age,gender,blood type,smoking history,family history of lung cancer were irrelevant to subcarinal lymph nodes metastasis.Multivariable logistic regression analysis showed that tumor location,upper mediastinal lymph nodes and interlobar lymph nodes metastasis were independent risk factors of subcarinal lymph nodes metastasis.Conclusion Subcarinal lymph nodes metastasis can be more easily found in patients with adenocarcinoma and lower lobe tumor.It is not necessary to dissect subcarinal lymph nodes in upper lobe squamous carcinoma or right upper lobe carcinoma in T1 a stage,when hilar lymph nodes,interlobar lymph nodes and superior mediastinum lymph nodes are negative. |
