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N分类 N: 区域淋巴结 Nx | | | | | 转移至同侧支气管周围淋巴结和/或同侧肺门淋巴结和肺内淋巴结，包括原发肿瘤直接累及同侧第10-14站淋巴结 | | 转移到同侧纵隔和/或隆突下淋巴结，即累及同侧纵隔第2-9站淋巴结 | | 转移到对侧纵隔、对侧肺门、同侧或对侧斜角肌或锁骨上淋巴结 |
淋巴结图谱共定义了7个淋巴结区域。 7个淋巴结区域分别为锁骨上区、上区、主动脉肺动脉区、隆突下区、下区、肺门区／叶间区及周围区。
N分类：锁骨上区和上纵隔淋巴结定义
N分类：中下纵隔、肺门和周围区淋巴结定义
N分类-淋巴结图
N分类与非小细胞肺癌的生存/预后
表1．按转移淋巴结站数
| 事件/例数 | 中位生存期(MST) | 60 个月 | N1 单个 | 438/1135 | NR | 58% | N1 多个 | 153/325 | 60.9 | 50% | N2 单个 | 261/602 | 67 | 52% | N2 单个+N1 | 304/582 | 43.9 | 41% | N2 多个 N2 | 462/796 | 38 | 36% |
表2．按纵隔淋巴结转移数量和比例 类别 | 转移淋巴结 | 5年生存率 | 比较 | P 值 | 按照纵隔淋巴结转移的数量 | 1-2个 | 63.4% |
|
| 3-5个 | 32.4% | Vs. 1-2 | 0.015 | ≥6个 | 18.2% | Vs.3-5 | 0.134 | 按照纵隔淋巴结转移的比例 | ≤15% | 56.0% |
|
| 15%-40% | 27.3% | Vs. -15 | 0.011 | ≥40% | 5.04% | Vs.15-40 | 0.011 |
【参考文献】
- Ramon Rami-Porta. International Association for the Study. IASLC Staging Handbook in Thoracic Oncology, 2nd edition. 2016
- Detterbeck FC, Boffa DJ, Kim AW, Tanoue LT, The 8th Edition Lung Cancer Stage Classification, CHEST (2016), doi: 10.1016/j.chest.2016.10.010.
- Goldstraw P et al. J Thorac Oncol. 2016;11(1):39-51
- Jin Y,Comparison of the 7(th) and proposed 8(th) editions of the AJCC/UICC TNM staging system for non-small cell lung cancer undergoing radical surgery.Sci Rep. 2016 Sep 19;6:33587.
- Asamura H et al. J Thorac Oncol 2015 Dec;10(12):1675-84.
- Ito M ,Classifications of n2 non-small-cell lung cancer based on the number and rate of metastatic mediastinal lymph nodes. Clin Lung Cancer. 2013 Nov;14(6):651-7.
- Eberhardt W et al. J Thorac Oncol 2015;10(11):1515-22.
- Hammar SP. Common Tumors. In: Dail DH, Hammar SP, editors. Pulmonary Pathology. 2nd ed. New York: Springer-Verlag; 1994. p. 1138.
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