多病灶肺癌的外科诊治

外科研究与新技术 ›› 2013, Vol. 2 ›› Issue (3): 149-151.

多病灶肺癌的外科诊治

姜格宁

同济大学附属上海市肺科医院胸外科，上海 200433

出版日期:2013-09-28 发布日期:2013-03-25
作者简介:姜格宁(1959-),男,同济大学附属上海市肺科医院胸外科主任医师,教授,博士生导师。

Surgical treatment of multiple lung cancer

JIANG Ge-ning

Department of Thoracic Surgery,Shanghai Pulmonary Hospital,Tongji University School of Medicine,Shanghai 200433 China

Online:2013-09-28 Published:2013-03-25

摘要/Abstract

摘要： 肺癌治疗策略是结合组织类型、肿瘤大小、TNM分期、患者体力状态等多种因素综合制定的。在对肺癌患者进行评估过程中，经常会发现原发肿瘤以外其它的肿瘤结节，它可以位于原发肿瘤的同一肺叶、同侧不同肺叶，或者对侧肺组织中，也可能以卫星灶的形式出现在原发肿瘤的周围。这些肿瘤结节的出现会影响肺癌的TNM分期和治疗方案的制定。根据大宗回顾性分析的生存结果，第七版肺癌分期中把原发肿瘤所在肺叶内出现转移结节者由原来的T4归为T3，原发肿瘤所在肺叶以外的同侧肺叶出现转移结节者由原来的M1归为T4，对侧肺出现转移结节者由原来的M1为M1a。第七版肺癌分期把原发肿瘤以外的肿瘤结节假设为原发肿瘤的转移灶来进行分期的，但是在临床工作中这些肿瘤结节并非全部为原发肿瘤的转移灶，肿瘤结节同样为原发肺癌的情况也时有发生。此时我们称之为同时多原发肺癌(synchronous multiple primary lung cancer，多原发肺癌)。随着螺旋CT以及PETCT等影像学技术的普遍应用，越来越多的多病灶肺癌被发现，当病灶的组织学类型不同时，诊断多原发肺癌比较容易，当病灶的组织学类型相同时，我们很难区分这些多病灶肺癌是多原发肺癌还是肺癌伴肺内转移。

关键词: 肺癌, 外科治疗

Key words: Lung Cancer, Surgical Treatment

中图分类号:

R655.3

姜格宁. 多病灶肺癌的外科诊治[J]. 外科研究与新技术, 2013, 2(3): 149-151.

JIANG Ge-ning. Surgical treatment of multiple lung cancer[J]. Surgical Research and New Technique, 2013, 2(3): 149-151.

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