Noninvasive clinical staging modalities for lung cancer.
Noninvasive clinical staging modalities for lung cancer.
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DOI：
10.1002/(sici)1098-2388(200003)18:2
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发表时间：
2000-03
期刊：
影响因子：
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通讯作者：
C. Lau;D. Harpole
中科院分区：
文献类型：
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作者：
C. Lau;D. Harpole
肺癌的临床分期有助于确定疾病的程度，并将患者分为类似的治疗和预后类别。临床分期的主要目标是将具有潜在可切除疾病的患者与不可切除的患者分开。通过病史和体格检查结合实验室检查值对患者进行初步评估可提示疾病的转移性扩散。当异常时，这些临床因素可能在预测预后方面具有价值，但它们在早期肺癌中的使用是有限的，因为该组中症状，体格检查结果和实验室异常的患病率较低。对于临床分期，患者几乎总是接受后前位和侧位胸片以及胸部和上腹部的计算机断层扫描（CT），包括肝脏和肾上腺。虽然CT扫描提供了精细的解剖信息，但它不是确定淋巴结状态的最佳方法。在过去的几年里，CT扫描结合正电子发射断层扫描（PET）使用氟脱氧葡萄糖（FDG）显着提高了临床分期的准确性。FDG-PET的使用仍然被定义为原发性肿瘤、淋巴结受累和转移性疾病的非侵入性评价。尽管最近在肺癌的放射学评估方面取得了进展，但仍然经常进行侵入性取样以进行病理学确认。
Clinical staging of lung cancer helps to determine the extent of disease and stratify patients into similar therapeutic and prognostic categories. A primary goal of clinical staging is to separate patients with potentially resectable disease from those that are unresectable. Initial assessment of the patient by history and physical examination combined with laboratory values can suggest metastatic spread of the disease. When abnormal, these clinical factors may have value in terms of predicting prognosis, but their use in early stage lung cancer is limited because of the low prevalence of symptoms, physical exam findings, and laboratory abnormalities in this group. For clinical staging, patients almost always undergo a postero-anterior and lateral chest radiograph and a computed tomography (CT) scan of the chest and upper abdomen to include the liver and adrenal glands. Although CT scanning provides exquisite anatomic information, it is less than optimal for determining lymph node status. Over the last several years, CT scanning combined with positron-emission tomography (PET) using fluorodeoxyglucose (FDG) has significantly improved the accuracy of clinical staging. The use of FDG-PET continues to be defined in the non-invasive evaluation of the primary tumor, nodal involvement, and metastatic disease. Despite the recent advancements in radiologic assessment of lung cancer, invasive sampling is still often performed for pathologic confirmation.