抽象
精确纵隔淋巴结(LN)分期是在否则可操作非小细胞肺癌(NSCLC)必要的,因为它确定在新辅助试随后的处理和可能列入。纵隔镜和计算机断层扫描(CT)的作用仍然存在争议。为了确定当前的CT扫描仪的精确度,进行的前瞻性研究。从1993年4月至1995年9月,100名连续NSCLC患者无远处转移的CT和宫颈纵隔镜进行分期。Naruke的地图被用于分类,和大于1cm的LN被认为CT阳性。有91名男性和女性9例,用64(范围45-82)岁的平均年龄。五个十九肿瘤是中枢和外周41,64右侧和36左侧。开胸纵隔LN采样是在74例患者进行的,具有多级阶段IIIA或IIIB期疾病的患者非手术。二十五(25%)mediastinoscopies是积极的,三个是假阴性(3%)。有29个假阳性CT扫描和12假阴性。 Overall sensitivity and specificity of CT were 63 and 57%, respectively, and of mediastinoscopy 89 and 100%, respectively. Positive and negative predictive values of CT were 41 and 77%, respectively, and of mediastinoscopy 100 and 96%, respectively. Accuracy of CT was 59% and of mediastinoscopy 97%. Accuracy of CT was lowest for left-sided and centrally located tumours, and for LN station 7. Even with current computed tomography scanners, sensitivity and specificity remain low. Although overall cost may increase, routine cervical mediastinoscopy is necessary for precise staging of non-small cell lung cancer, and subcarinal lymph nodes should be routinely sampled.