Background: To investigate the characteristics of proximal bronchial invasion of lung cancer , and to provide some insights into the treatment of lung cancer by bronchoplasty.
Methods: Proximal bronchi of 58 operatively resected specimens of lung cancer by bronchoplasty were selected for different cross-sectional pathological study.
Results: The ratio of cancer remnant of incision margin in the patients of bronchial wedge resection was significantly higher than that of sleeve resection ( P < 0. 01) . Of the cancerous invasion at the proximal bronchial wall , 96. 1 % was observed to be less than 1. 5cm apart from the margin of the cancer. The direct invasion of tumour cells through the mucous layer , submucosal layer and multiple layers was 3. 9 % , 23. 5 % and 72. 5 % respectively. The extension of cancer infiltration was closely correlated with the histopathologic type of cancer , mode of invasion and TNM staging. The indirect invasion of metastatic lymph nodes in adenocarcinoma was more likely at the adventitial layer of proximal bronchial wall.
Conclusions: For radical operation , it is imperative to keep a distance of 1. 5cm or more between the incision margin of the bronchus and the tumor margin , to take sleeve lobectomy or pneumonectomy and to completely clear the hilar and mediastinal lymph nodes.