title: [Role of pulmonary segmental and sub-segmental lymph nodes in pathological staging of lung cancer].
abstract: OBJECTIVE
  To investigate the metastatic rate of segmental and/or sub-segmental lymph nodes and their roles in pathological staging after a major pulmonary resection.
  
  
  METHODS
  This prospective study recruited 90 cases of pulmonary resection performed at our department from February 2007 to February 2008. Hilar lymph nodes (No. 10), interlobar nodes (No. 11), lobar nodes (No. 12), segmental nodes (No. 13) and subsegmental nodes (No. 14) were resected and their clinic data analyzed.
  
  
  RESULTS
  (1) The median number of total lymph nodes harvested, mediastinal nodes, nodes from No. 10-14 and nodes from No. 13-14 were 29 (11-50), 17 (6-35), 12 (2-26) and 4 (1-17) respectively. Lymph node metastatic rate from No.10, No. 11, No. 12, No. 13 + 14 were 12.2%, 6.7%, 23.3% and 38.9% respectively. (2) Forty-two cases of N0 and 27 cases of N1 were diagnosed in this group. The N1 subgroup included 12 cases of No. 13-14 metastasis solely and 15 cases of No. 10-12 and No. 13-14 metastasis simultaneously. If an analysis of No. 13-14 was omitted, the diagnostic accuracy of N0 could only reach 77.8% and 44.4% cases would be under-staged from N1. (3) In 33 cases of peripheral lung cancers smaller than 3 cm in diameter, 12.1% of metastatic lymph nodes from No.12-13 would be left in the original place if a segmental resection was performed. Similarly, 18.2% of metastatic lymph nodes could be neglected for wedge resection cases.
  
  
  CONCLUSIONS
  Metastasis to segmental or subsegmental lymph nodes accounts for a large part of lung cancer patients. Therefore an analysis of these nodes can improve the accuracy of pathological staging. Secondly, limited pulmonary resection needs to follow a strict indication in consideration of the potential metastasis to segmental or subsegmental lymph nodes in peripheral small lung cancers.
authors.affiliation: Key Laboratory of Carcinogenesis & Translational Research (Ministry of Education), Department of Thoracic Surgery II, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing 100142, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Wu
authors.forename: Shi
authors.initials: S
authors.lastname: Yan
authors.forename: Qing-feng
authors.initials: QF
authors.lastname: Zheng
authors.forename: Chao
authors.initials: C
authors.lastname: Lü
authors.forename: Yu-zhao
authors.initials: YZ
authors.lastname: Wang
authors.forename: Jia
authors.initials: J
authors.lastname: Wang
authors.forename: Yue
authors.initials: Y
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology*; D008175:Lung Neoplasms / Q000473:pathology*; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies