72美国胸科协会纵隔淋巴结分区彩图-第2页
上亿文档资料，等你来发现
72美国胸科协会纵隔淋巴结分区彩图-2
JournalofThoracicOncolog；Locatedintheareaaroundth；Locatedalongthesubsegmen；Locatedalongthesegmental；JapanLungCancerSocietyMa；TABLE1.(Continued)；Optionalnotationsforsubc；showninFigu
JournalofThoracicOncology?Volume4,Number5,May2009TheIASLCLungCancerStagingProjectLocatedintheareaaroundthelobarbranches,whicharesubclassi?edNodesadjacenttothedistallobarbronchiintothreegroups:#12u:Upperlobarlymphnodes#12m:Middlelobarlymphnodes#12l:LowerlobarlymphnodesLocatedalongthesubsegmentalbranchesLocatedalongthesegmentalbranchesJapanLungCancerSocietyMapTABLE1.(Continued)Optionalnotationsforsubcategoriesofstation.MD-ATS,Mountain-Dreslermodi?cationoftheATSIASLC,InternationalassociationforATS,AmericanThoracicSociety.showninFigure3andTable1,respectively.ThereareseveralnotablechangesrelativetotheNarukeandMD-ATSmaps.Conciseandanatomicallydistinctdescriptionsarenowprovidedforalllymphnodestationsandespeciallyfortheupperandlowerbordersoflymphnodestations1through10whereitiscriticaltoavoidoverlapinde?nitions.Asaresult,thepleuralre?ectionnolongerservesastheborderbetweennodalstations4and10,whicharenowde?nedbyanatomiclandmarksthataremorereliablyidenti?edonimagingstudiesandatendoscopyandsurgery.Thesupraclavicularandster-nalnotchlymphnodeswhichwerenotpreviouslyidenti?edasalymphnodestationseparatefromtheintrathoracicnodesarenowclearlydescribedaslevel1.Thediscrepanciesbetweenlevels2and4lymphnodesintheNarukeandMD-ATSlymphnodemaps(notedabove)havebeenre-solvedbyprovidingmoreprecisede?nitions.ThearbitrarydivisionalongthemidlineofthetracheacreatedbytheATShasbeeneliminated.Recognizingthatlymphaticdrainageinthesuperiormediastinumpredominantlyoccurstotherightparatrachealareaandextendspastthemidlineofthetrachea,theboundarybetweentheright-andleft-sidedlevels2and4lymphnodeshasbeenresettotheleftlateralwallofthetrachea(Figures3,4).Thearbitrarydesignationoflevel3lymphnodesasnodesoverlyingthemidlineofthetracheaintheNarukemaphasbeeneliminatedbecausethesenodesarenotreliablydistinguishablefromlevels2and4andaregenerallyremoveden-blocwithlevel4duringamediastinalcomponentofsystematicnodaldissectionfromtheright.Thedesignationofprevascular(anteriormediastinal)andretro-trachealnodesas3aand3phasbeenretainedandclari?ed.Theentiresubcarinalgroupoflymphnodes,previouslylabeledaslevel7intheMD-ATSmapbutdividedintolevels7and10intheNarukemapisnowde?nedaslevel7,againwithpreciseanatomicborders.Speci?cboundariesarealsoprovidedforthefrequentlyproblematicseparationbetweenlevels4and10ontheright,levels5and10ontheleft,andlevels10and11bilaterally.Exploratoryanalysesofoverallsurvivalinrelationshiptovariouslevelsoflymphnodeinvolvementpreviouslygroupedtogethercertainlymphnodestationsinto“zones.”8Thezoneconceptisproposedforfuturesurvivalanalyses,notforcurrentstandardnomencla-ture.Itishopedthatthisconceptwillproveofvaluetooncologistsandradiologistswhendealingwithlargenodalmassesthattransgressindividualnodalstations.Figures4ACFillustratehowtheanatomicde?nitionsofthelymphnodestationsareappliedtoclinicalstagingonCTscansintheaxial(Figures4ACC),coronal(Figure4D),andsagittal(Figures4E,F)views.Thedivisionbetweenrightandleftsidednodesatlevels2and4isalsoshown(Figures4A,B).IASLCMapNodesadjacenttothesegmentalbronchi#14SubsegmentalNodes#13SegmentalNodes#12LobarNodesMD-ATSMapNodesaroundthesubsegmentalbronchiAdjacenttothesubsegmentalbronchiAdjacenttothesegmentalbronchiAdjacenttothelobarbronchiDISCUSSIONScienti?cinvestigationintothepatternsoflymphaticdrainageofthelungdatesbacktotheearly1900s.However,Rouvie`re9isgenerallycreditedwiththe?rstcomprehensivestudyofthelymphaticdrainageofthelung.In1929,hede-scribedthelymphnodesdrainingeachlobeofthelungasdeterminedbyselectiveinjectionofthelymphaticsin200humanspecimens.Inhisreport,henotedthatitwaspossibletoaCopyright?2009bytheInternationalAssociationfortheStudyofLungCancer573Ruschetal.JournalofThoracicOncology?Volume4,Number5,May2009FIGURE3.TheInternationalAssociationfortheStudyofLungCancer(IASLC)lymphnodemap,includingtheproposedgroupingoflymphnodestationsinto“zones”forthepurposesofprognosticanalyses.predictwhichlymphnodeswouldbeinvolvedbasedonthelocationoftheprimarytumor.Theillustrationsoflobarlym-phaticdrainageincludedinthisseminalarticlehavebeencor-roboratedbymorerecentstudiesandarestillaccuratetoday.Duringthe1950sand1960sadditionalstudiesexpandedourknowledgeofthepatternsofpulmonaryandmediastinallym-574Copyright?2009bytheInternationalAssociationfortheStudyofLungCancerJournalofThoracicOncology?Volume4,Number5,May2009TheIASLCLungCancerStagingProjectFIGURE4.ACF:IllustrationsofhowtheInternationalAssociationfortheStudyofLungCancer(IASLC)lymphnodemapcanbeappliedtoclinicalstagingbycomputedtomographyscaninaxial(ACC),coronal(D),andsagittal(E,F)views.TheborderbetweentherightandleftparatrachealregionisshowninAandB.Ao,AV,Br,IA,IV,LA,LIV,LSA,PA,PV,RIV,SVC,superiorvenacava.phaticdrainageespeciallyinpatientswithlungcancer.10,11Morerecently,Riquetde?nedthelymphaticdrainageoflungseg-mentsincludingdirectdrainagetomediastinallymphnodesbyinjectingthesubpleurallymphaticsof483lungsegmentsin260adultcadavers.12Overall,thesevariousstudiesindicatedthatmediastinallymphnodemetastasesfromrightupperlobetu-morsoccurpredominantlyintherightparatrachealarea,whilethosefromleftupperlobetumorsoccurmostfrequentlyintheperi-andsubaorticlymphnodes,andthosefrommiddleandlowerlobetumorsoccurinthesubcarinal,thentherightpara-trachealnodes.Directdrainagetothemediastinallymphnodesbypassingthehilarandinterlobarnodesorso-calledskipme-tastases,canbeseeninupto25%oflungsegmentsinjectedexperimentally.12Clinically,skipmetastaseshavebeenreportedin7to26%ofresectedlungcancerspecimensandaremostfrequentinupperlobetumorsandinadenocarcinomas.13,14Studiesofthepatternsoflymphaticdrainageofthelunggraduallyledtoanunderstandingoftheimportanceoflymphnodestaginginthemanagementoflungcancers.Cahaniscreditedwiththe?rstdescriptionofasystematicapproachtohilarandmediastinallymphnodedissection,initiallyin1951inconjunctionwithpneumonectomy,15andlater,in1960,inasso-ciationwithlobectomy.16Shortlythereafter,Ishikawaintro-ducedthedissectionproposedbyCahantoJapanandbasedontheresultsofpatientsundergoingpulmonaryresectionwithhilarandmediastinallymphnodedissectionbyIshikawaandhisCopyright?2009bytheInternationalAssociationfortheStudyofLungCancer575Ruschetal.JournalofThoracicOncology?Volume4,Number5,May2009team,Narukecreatedhislymphnodemapin1967.TheJapanLungCancerSocietyendorsedlymphnodedissectionandtheNarukemapasstandardprocedureforlungcancerresectioninInNorthAmericaduringthe1960s,thegroupatMemorialSloan-KetteringCancerCenter(ofwhichCahanwaspart)devisedalungcancerstagingsystemandlymphnodenomenclaturesimilartotheNarukesystem.19However,ulti-mately,MSKCCandotherNorthAmericangroupsadoptedtheNarukemapwhichwasthenacceptedin1976bytheAJC(AmericanJointCommitteeforCancerStagingandEndResultsReporting)forstandarduseinthestagingoflungcancers.Theneedtoprovidemorepreciseanatomicde?nitionsforintratho-raciclymphnodestationsinawaythatwouldbeusefulforradiologists,pathologists,andallcliniciansinvolvedinthecareoflungcancerpatientsledtothedevelopmentoftheATSandMD-ATSmaps.Thepresenceofthesetwomappingsystemswasacknowledgedstartingin1997withthe4theditionoftheUICCTNMAtlas20andthe5thand6theditionsoftheAJCCstagingmanuals.21Duringthistime,theJapanLungCancerSocietyre?nedtheanatomicde?nitionsofthelymphnodestationsintheNarukemap.DetaileddescriptionsaswellasanatomicandCTillustrationsprovidedintheJapanLungCancerSocietymonographClassi?cationofLungCanceres-tablishednationalstandardsofstagingandpathologicclassi?-cationforlungcancerwithadegreeofprecisionunparalleledelsewhereintheworld.Unfortunately,anEnglisheditionofthismonographwasnotpublisheduntil2000.6Therefore,althoughclinicians,especiallysurgeons,weregenerallyawareofdiscrep-anciesbetweentheJapaneseandMD-ATSmapandknewthatsuchdifferencescouldaffectanalysesoftreatmentoutcomesbecauseoftheirimpactonstaging,theextentofthesediscrep-ancieswasnotevidentuntilrecently.Thedif?cultiesinassess-ingtheoutcomesoftreatmentforpatientsstagedaccordinglytodifferentlymphnodemapsareemphasizedbythecomplexitiesandirreconcilablediscrepanciesencounteredduringanalysesoftheNdescriptorsintheIASLCdatabase.8However,discrepan-ciesinthelabelingoflymphnodestationsoccurevenamongexperiencedJapaneseandnon-JapanesesurgeonsutilizingonlytheNarukemap.Inonestudy,aJapanesesurgeonandaEuropeansurgeonwhowerejointlypresentduringpulmonaryresectionsperformedon41patientsdesignatedinamannerblindedtooneanothereachlymphnodestationremovedduringasystematiclymphnodedissection.Thetotalconcordanceratewasonly68.5%.Ofevengreaterconcernwasthatin34.1%ofpatients,lymphnodesdesignatedasN1byonesurgeonwerelabeledasN2bytheothersurgeon.22Clearly,asingleinterna-tionallyacceptedlymphnodemapisneededforfuturestudiesoflungcancertreatmentandrevisionsofthestagingsystem.Thisisespeciallyimportantduringthecomingdecadesasanincreas-ingnumberofdevelopingcountrieswithlargelungcancerpatientpopulationsthathavenotsystematicallyusedeitheronelymphnodemaportheotherinthepastbegintocontributetheirdatatotheprospectiveinternationalIASLCdatabase.Analysesofoutcomeinrelationshiptotheextentoflymphnodeinvolvementhavebeenusedtoproposechangestothelungcancerstagingsystem,toselectpatientsformultimodalitytreat-mentandtostratifypatientswithinclinicaltrials.Thepublishedsurgicalliteratureisrepletewithsuchanalyses,whicharetoonumeroustolistintheirentiretyhere.13,23C33Areasofcontinuingcontroversyregardingtherelationshipbetweenlymphnodesmetastasesandoverallsurvivalinclude:intranodalversusex-tranodaldisease23;singleversusmultiple(eitherN1orN2)lymphnodestationdisease13,24,27C32;thespeci?csitesoflymphnodemetastasesinrelationshiptothelocationoftheprimarytumor24,28,31;thesigni?canceofskipmetastases13;andtheneedforsystematiclymphnodedissectionversusalessextensivelymphnodesampling,25especiallyfortumorslessthan2cminsize.26AnalysesoftheIASLCdatabasesuggestedthatleftupperlobetumorswithskipmetastasesintheAPzone(levels5and6)wereassociatedwithamorefavorableprognosisthanotherN2subsets.Inaddition,analysesofthepotentialimpactofthenumberofinvolvedlymphnodezonesonsurvivalfoundthreegroupstohavesigni?cantlydifferentsurvivalrates:patientswhohadN1singlezonedisease,thosewhohadeithermultipleN1orsingleN2zonemetastases,andthosewhohadmultipleN2lymphnodezonesinvolved.However,a?rmrecommendationforchangesintheNdescriptorsandstagegroupingscouldnotbemadebecauselargernumbersofpatientswithpreciselymphnodestagingthatcanbeanalyzedacrosseachTstagearerequiredtoyieldstatisticallyvalidresults.Groupingtogetherpatientgroupsaccordingtolymphnode“zones”wasamechanismusedintheanalysisoftheretrospectiveIASLCdatabasetoreconciletheNarukeandtheMD-ATSlymphnodemapswhichseemedjusti?edonthebasisofexplor-atoryanalyses.8Prospectiveanalysesinlargernumberofuniformlystagedpatientsarerequiredtodeterminewhethergroupinglymphnodestationstogetherinto“zones,”aspro-posedhere,istrulyappropriateforanalysesofsurvival.ThecontinuingcontroversiesaboutthecurrentNclassi?cationsandthechallengesencounteredbytheIASLCstagingcom-mitteeinanalyzinganinternationaldatabaseattesttotheneedforaninternationallyacceptedlymphnodemapthatwillsupportanuniformapproachtolymphnodestaging.34ItisourhopethatwidespreadimplementationoftheIASLClymphnodemapwillprovidethebasisforfutureanalysestoresolvemanyofthecontroversiesaboutNstageclassi?cationthatcurrentlyaffectpatientcareandclinicaltrials.EliLillyandCompanyprovidedfundingtosupporttheInternationalAssociationfortheStudyofLungCancer(IASLC)StagingCommittee’sworktosuggestrevisionstothe6theditionoftheTNMclassi?cationforLungCancer(stag-ing)througharestrictedgrant.LillyhadnoinputintotheCommittee’ssuggestionsforrevisionstothestagingsystem.TheprojectwasalsosupportedbytheAJCCgrant“Improv-ingAJCC/UICCTNMCancerStaging.”WearegratefulforthepatientassistanceofeditorMelodyOwens.TheauthorsthankDr.AnnieFrazierforhersuperbcontributiontothecreationofthe?guresforthismanuscript.ACKNOWLEDGMENTSAPPENDIXIASLCInternationalStagingCommitteeP.Goldstraw(Chairperson),RoyalBromptonHospital,ImperialCollege,London,UK;H.Asamura,NationalCancerCentreHospital,Tokyo,JD.Ball,PeterMacCallum576Copyright?2009bytheInternationalAssociationfortheStudyofLungCancerJournalofThoracicOncology?Volume4,Number5,May2009TheIASLCLungCancerStagingProjectCancerCentre,EastMelbourne,AV.Bolejack,Can-cerResearchandBiostatistics,Seattle,Washington,USA;E.Brambilla,LaboratoiredePathologieCellulaire,GrenobleCedex,FP.A.Bunn,UniversityofColoradoHealthSciences,Denver,CD.Carney,MaterMisericordiaeHospital,Dublin,IK.Chansky,CancerResearchandBiostatistics,Seattle,Washington,USA;T.LeChevalier(resigned),InstituteGustaveRoussy,Villejuif,FJ.Crowley,CancerResearchandBiostatistics,Seattle,Wash-ington,USA;R.Ginsberg(deceased),MemorialSloan-Ket-teringCancerCenter,NewYork,USA;D.Giroux,CancerResearchAndBiostatistics,Seattle,Washington,USA;P.Groome,Queen’sCancerResearchInstitute,Kingston,On-tario,CH.H.Hansen(retired),NationalUniversityHospital,Copenhagen,DP.VanHoutte,InstituteJulesBordet,Bruxelles,BJ.-G.Im,SeoulNationalUniversityHospital,Seoul,SouthKJ.R.Jett,MayoClinic,Rochester,Minnesota,USA;H.Kato,(retired),TokyoMedicalUniversity,Tokyo,JC.Kennedy,UniversityofSydney,Sydney,AM.Krasnik,GentofteHospital,Copenhagen,DJ.vanMeerbeeck,UniversityHospi-tal,Ghent,BT.Naruke(deceased),SaiseikaiCentralHospital,Tokyo,JE.F.Patz,DukeUniversityMedicalCenter,Durham,NorthCarolina,USA;P.E.Postmus,VrijeUniversiteitMedicalCenter,Amsterdam,theNR.Rami-Porta,HospitalMutuadeTerrassa,Terrassa,SV.Rusch,MemorialSloan-KetteringCancerCenter,NewYork,USA;J.P.Sculier,InstituteJulesBordet,Bruxelles,BZ.Shaikh,RoyalBromptonHospital,London,UK;F.A.Shepherd,UniversityofToronto,Toronto,Ontario,CY.Shimosato(retired),NationalCancerCentre,Tokyo,JL.Sobin,ArmedForcesInstituteofPathology,WashingtonDC;W.Travis,MemorialSloan-KetteringCancerCenter,NewYork,USA;M.Tsuboi,TokyoMedicalUniversity,Tokyo,JR.Tsuchiya,NationalCancerCentre,Tokyo,JE.Vallieres,SwedishCan-cerInstitute,Seattle,Washington,USA;J.Vansteenkiste,LeuvenLungCancerGroup,BYohWatanabe(deceased),Ka-nazawaMedicalUniversity,Uchinada,JandH.Yokomise,KagawaUniversity,Kagawa,Japan.REFERENCES1.NarukeT.[Thespreadoflungcanceranditsrelevancetosurgery.]NipponKyobuGekaGakkaiZasshi7C1621.2.NarukeT,SuemasuK,IshikawaS.Lymphnodemappingandcurabilityatvariouslevelsofmetastasisinresectedlungcancer.JThoracCar-diovascSurgC839.3.TisiGM,FriedmanPJ,PetersRM,etal.Clinicalstagingofprimarylungcancer.AmRevRespirDisC664.4.MountainCF,DreslerCM.Regionallymphnodeclassi?cationforlungcancerstaging.Chest8C1723.5.ZielinskiM,Rami-PortaR.ProposalsforchangesintheMountainandDreslermediastinalandpulmonarylymphnodemap.JThoracOncolC6.6.TheJapanLungCancerSociety.Classi?cationofLungCancer.Tokyo:Kanehara&Co;2000.7.GoldstrawP,CrowleyJ,ChanskyK,etal.TheIASLClungcancerstagingproject:proposalsfortherevisionoftheTNMstagegroupingsintheforthcoming(seventh)editionoftheTNMclassi?cationofmalignanttumours.JThoracOncolC714.8.RuschVW,CrowleyJ,GirouxDJ,etal.TheIASLClungcancerstagingproject:proposalsfortherevisionoftheNdescriptorsintheforthcom-ingseventheditionoftheTNMclassi?cationforlungcancer.JThoracOncolC612.9.Rouvie`reH.Lesvaisseauxlymphatiquesdespoumonsetlesganglionsvisce′rauxintrathoraciques.AnnAnatPatholC158.10.NohlHC.Aninvestigationintothelymphaticandvascularspreadofcarcinomaofthebronchus.ThoraxC185.11.PennellTC,BradshawHH.Anatomicalstudyoftheperipheralpulmo-narylymphatics.JThoracCardiovascSurgC634.12.RiquetM,HiddenG,DebesseB.Directlymphaticdrainageoflungsegmentstothemediastinalnodes.Ananatomicstudyon260adults.JThoracCardiovascSurgC632.13.RiquetM,Manac’hD,SaabM,LePimpec-BarthesF,DujonA,DebesseB.FactorsdeterminingsurvivalinresectedN2lungcancer.EurJCar-diothoracSurgC304.14.LibshitzHI,McKennaRJJr,MountainCF.Patternsofmediastinalmetastasesinbronchogeniccarcinoma.ChestC232.15.CahanWG,WatsonWL,PoolJL.Radicalpneumonectomy.JThoracCardiovascSurgC473.16.CahanWG.Radicallobectomy.JThoracCardiovascSurg1960;39:555C572.17.TsuchiyaR.Thecompletehilar-mediastinallymphnodedissection.AnnItalChir.18.NarukeT.Mediastinallymphnodedissection.InFGPearson,JDeslau-riers,RJGinsberg(Eds.),ThoracicSurgery,1stEd.NewYork:Churchill-Livingston,1995.Pp.909C917.19.MartiniN.Mediastinallymphnodedissectionforlungcancer.Thememorialexperience.ChestSurgClinNAmC203.20.UnionInternationaleContreleCancer.Lungandpleuraltumours.InPHermanek,RVPHutter,LHSobin,etal.(Eds.),TNMAtlas,4thEd.Berlin:Springer,1997.Pp.153C166.21.AmericanJointCommitteeonCancer.AJCCCancerStagingHandbook.NewYork:Springer-Verlag,2002.22.WatanabeS,LadasG,GoldstrawP.Inter-observervariabilityinsys-tematicnodaldissection:comparisonofEuropeanandJapanesenodaldesignation.AnnThoracSurgC249.23.MartiniN,FlehingerBJ,ZamanMB,BeattieEJJr.Resultsofresectioninnon-oatcellcarcinomaofthelungwithmediastinallymphnodemetastases.AnnSurgC397.24.PattersonGA,PiazzaD,PearsonFG,etal.Signi?canceofmetastaticdiseaseinsubaorticlymphnodes.AnnThoracSurgC159.25.IzbickiJR,ThetterO,HabekostM,etal.Radicalsystematicmediastinallymphadenectomyinnon-smallcelllungcancer:arandomizedcon-trolledtrial.BrJSurgC235.26.SugiK,NawataK,FujitaN,etal.Systematiclymphnodedissectionforclinicallydiagnosedperipheralnon-smallcelllungcancerlessthan2cmindiameter.WorldJSurgC295.27.AndreF,GrunewaldD,PignonJ,etal.SurvivalofpatientswithresectedN2non-smallcelllungcancer:evidenceforasubclassi?cationandimplications.JClinOncol1C2989.28.IchinoseY,KatoH,pletelyresectedstageIIIAnon-smallcelllungcancer:thesigni?canceofprimarytumorlocationandN2station.JThoracCardiovascSurgC808.29.OkadaM,SakamotoT,YukiT,etal.BorderbetweenN1andN2stationsinlungcarcinoma:lessonsfromlymphnodemetastaticpatternsoflowerlobetumors.JThoracCardiovascSurgC830.30.KellerSM,VangelMG,WagnerH,etal.Prolongedsurvivalinpatientswithresectednon-smallcelllungcancerandsingle-levelN2disease.JThoracCardiovascSurgC137.31.InoueM,SawabataN,TakedaS,etal.Resultsofsurgicalinterventionforp-stageIIIA(N2)non-smallcelllungcancer:acceptableprognosispre-dictedbycompleteresectioninpatientswithsingleN2diseasewithprimarytumorintheupperlobe.JThoracCardiovascSurg0C1106.32.OhtaY,ShimizuY,MinatoH,etal.Resultsofinitialoperationsinnon-smallcelllungcancerpatientswithsingle-levelN2disease.AnnThoracSurgC433.33.SakaoY,MiyamotoH,YamazakiA,etal.Thespreadofmetastaticlymphnodestothemediastinumfromleftupperlobecancer:resultsofsuperiormediastinalnodaldissectionthroughamediansternotomy.EurJCardiothoracSurgC547.34.GroomePA,BolejackV,CrowleyJJ,etal.TheIASLClungcancerstagingproject:validationoftheproposalsforrevisionoftheT,N,andMdescriptorsandconsequentstagegroupingsintheforthcoming(seventh)editionoftheTNMclassi?cationofmalignanttumours.JThoracOncolC705.Copyright?2009bytheInternationalAssociationfortheStudyofLungCancer577包含各类专业文献、应用写作文书、高等教育、外语学习资料、文学作品欣赏、各类资格考试、生活休闲娱乐、72美国胸科协会纵隔淋巴结分区彩图等内容。　
　 纵隔淋巴结分区_临床医学_医药卫生_专业资料。纵隔淋巴转移的 CT 分区 1996 ...协会提出新的肺癌淋巴 结分布图,目的是折中 NSRUKE 与美国胸科学会在淋巴结分区... 　 纵隔淋巴结分区_医药卫生_专业资料。纵隔淋巴结分区...AJCC(美国癌症学会)标准及 ATS(美国胸科学会)标准。...的水平线,方便地把所见到的淋巴结归入胸部淋巴结图... 　 纵膈淋巴结分区_临床医学_医药卫生_专业资料。纵隔淋巴结分区图谱(美国胸科协会)发表者:陈海石 (访问人次:805) 纵隔淋巴结分区的方法很多,目前采用美国胸科协会... 　Naruke(1978)提出,1983 年美国胸科协会(ATS)在 Naruke 分 区基础上进行了部分...1996 年 UICC 将两者统一,于 1997 年颁 布了新的淋巴结分布图,把纵隔、肺... 　 肺癌患者纵隔淋巴结分区_医药卫生_专业资料。为便于了解肺癌淋巴引流和手术准确记录以及癌灶由近及远 情况, 对肺癌胸腔内淋巴结进行了分区和淋巴 结划线。 淋巴结... 　 49页 免费 美国胸科协会纵隔淋巴结分... 10页 2财富值搜你所想,读你所爱...条解剖上的水平线,方便地把所 见到的淋巴结归入胸部淋巴结图中的 14 个区中... 　1983 年,美国胸科协会(American Thoracic Society,ATS...分布图,将纵隔淋巴结分为 9 组:1.最上 纵隔组;... 纵隔淋巴结分区 34页 1下载券 纵隔淋巴结 50页 ... 　第1 组淋巴结群:在上纵隔胸腔内上 1/3 气管的周围,其双侧以锁骨下动脉的上...1983 年美国胸科学会 (AmericanThoracic Society,ATS)对以往的淋巴结分区法作了... 　 纵隔淋巴结在CT影像上的新分区,对从事放化疗科及胸外、呼内科的人员很实用!...条解剖上的水平线,方便地把所 见到的淋巴结归入胸部淋巴结图中的 14 个区中...