肺癌是我国发生率及死亡率最高的恶性肿瘤,而非小细胞肺癌(NSCLC)占其中的80%。早期NSCLC仍以手术治疗为主。精准的淋巴结分期直接影响到患者的TNM分期、后续治疗方案及预后。近来,多个研究发现,胸腔镜手术(VATS)的淋巴结升级率(Nodal upstaging)低于传统开胸手术。这使人们开始怀疑VATS手术的淋巴结评估能否完全替代传统手术。产生这一现象的原因也值得胸外科医生进一步探讨。 Lung cancer is the highest incidence and mortality of malignant tumors in our country, and non-small cell lung cancer (NSCLC) accounts for 80% of them. Early NSCLC is still based on surgical treatment. Accurate lymph node staging directly affects the patient’s TNM staging, follow-up treatment and prognosis. Recently, several studies have found that VATS has a lower rate of Nodal upstaging than conventional thoracotomy. This has led to the question of whether lymph node assessment of VATS can completely replace traditional surgery. The reason for this phenomenon also deserves to be further explored by thoracic surgeons.