Risk factors and clinical significance of mediastinal lymph node metastasis of peripheral non-small cell lung cancer
10.13929/j.1003-3289.201906057
- Author:
Juan WANG
1
Author Information
1. Department of Radiology, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research [Ministry of Education]
- Publication Type:Journal Article
- Keywords:
Carcinoembryonic antigen;
Carcinoma;
non-small-cell lung;
Stage N2;
Tomography;
X-ray computed
- From:
Chinese Journal of Medical Imaging Technology
2019;35(10):1490-1494
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the risk factors and clinical significance of mediastinal lymph node metastasis in peripheral non-small cell lung cancer (NSCLC) patients. Methods: Clinical and CT examinations data of 45 peripheral NSCLC patients with chest CT findings as ipsilateral mediastinal maximum lymph node diameter ≥10 mm (clinical N2 stage) were retrospectively analyzed. Univariate and multivariate analyses were performed to identify the risk factors of mediastinal lymph node metastasis (pathological stage N2) in patients with peripheral NSCLC. The diagnostic efficacy of the risk factors was evaluated taken pathological results as the gold standards. Results: The false positive rate of mediastinal lymph node metastasis was 42.22% (19/45) in clinical N2 NSCLC patients diagnosed with CT before surgery. The minimum diameter of mediastinal lymph node in ipsilateral side of NSCLC lesion (P=0.022) and serum carcinoembryonic antigen (CEA) level (P=0.004) were identified as risk factors for mediastinal lymph node metastasis. And serum CEA level (P=0.007) was identified as an independent factor by multivariate analysis. After screening with preoperative CT diagnosis and serum CEA level, the false positive rate of mediastinal lymph node metastasis decreased to 7.69%(3/39). Conclusion: Preoperative serum CEA level is an independent factor for making definite diagnosis of mediastinal lymph node metastasis in clinical N2 stage patients with peripheral NSCLC, benefiting to reduce false positive rate of CT diagnosis.
