BRONCHOGENIC-CARCINOMA - ANALYSIS OF STAGING IN THE MEDIASTINUM WITH CT BY CORRELATIVE LYMPH-NODE MAPPING AND SAMPLING
BRONCHOGENIC-CARCINOMA - ANALYSIS OF STAGING IN THE MEDIASTINUM WITH CT BY CORRELATIVE LYMPH-NODE MAPPING AND SAMPLING
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DOI：
10.1148/radiology.182.2.1732943
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发表时间：
1992-02-01
期刊：
影响因子：
19.7
通讯作者：
GRILLO, HC
中科院分区：
文献类型：
--
作者：
MCLOUD, TC;BOURGOUIN, PM;GRILLO, HC
采用CT对143例肺癌患者进行前瞻性研究，以确定CT对纵隔淋巴结转移评估的准确性。纵隔淋巴结的定位依据美国胸科学会的淋巴结标测方案，如果纵隔淋巴结短轴直径超过1 cm，则认为纵隔淋巴结异常。所有患者均接受手术分期，包括单纯纵隔镜检查或纵隔镜检查加开胸手术。在手术分期时，所有可触及的结节要么被切除，要么被取样。CT诊断纵隔淋巴结的灵敏度为%，特异度为62%。CT对肿瘤累及单个结节的敏感性仅为44%。阻塞性肺炎的存在对CT的敏感性无明显影响，但特异性较低(43%)。转移的可能性随着淋巴结大小的增加而增加；然而，在19个短轴直径为2-4厘米的淋巴结中，有7个(37%)是增生的，没有转移。CT的相对不敏感度使得在纵隔镜检查或开胸手术时进行正规的结节取样对于发现淋巴结转移是必不可少的。
One hundred forty-three patients with bronchogenic carcinoma were studied prospectively with computed tomography (CT) to determine the accuracy of CT in the evaluation of mediastinal nodal metastases. Mediastinal lymph nodes were localized according to the lymph node mapping scheme of the American Thoracic Society and were considered abnormal if they exceeded 1 cm in short-axis diameter. All patients underwent surgical staging, which consisted of either mediastinoscopy alone or mediastinoscopy and thoracotomy. At the time of surgical staging, all accessible nodes were either removed or sampled. The sensitivity of CT for mediastinal nodes on a per-patient basis was 64%, with a specificity of 62%. The sensitivity of CT for individual nodal stations involved with tumor was only 44%. The presence of obstructive pneumonitis did not appreciably alter the sensitivity of CT, but the specificity was lower (43%). The likelihood of metastases increased with lymph node size; however, seven of 19 (37%) lymph nodes that measured 2-4 cm in short-axis diameter were hyperplastic and did not contain metastases. The relative insensitivity of CT makes formal nodal sampling at the time of mediastinoscopy or thoractomy essential to detect lymph node metastases.