Evaluation of Lymph Node Staging of Chest CT in NSCLCa.
- Author:
Sook Whan SUNG
1
;
Young Tae KIM
;
Doo Sang KIM
;
Joo Hyun KIM
;
Jung Ki LIM
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Lymph node;
Carcinoma;
non-small cell;
lung;
Tomography;
x-ray computed
- MeSH:
Axis, Cervical Vertebra;
Bronchiectasis;
Carcinoma, Non-Small-Cell Lung;
Diagnosis;
Humans;
Lung;
Lymph Node Excision;
Lymph Nodes*;
Patient Selection;
ROC Curve;
Sensitivity and Specificity;
Seoul;
Thorax*;
Tomography, X-Ray Computed*;
Tuberculosis
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
1998;31(3):271-278
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
In order to access the value of computed tomography in mediastinal LN staging of NSCLCa, 581 LN stations of 77 patients were selected from 552 patients who were diagnosed as Lung Ca and operated in Seoul National University Hospital from 1992 to 1995. The selection criteria were as follows ; the patients 1) whose preoperative chest CTs were available; 2) underwent curative resection (lobectomy or more) with complete lymph node dissection; 3) whose final pathologic diagnosis were proven to be non-small cell lung cancer. We adopted Receiver Operating Characteristic curve method to determine a proper size criterion for diagnosing malignant mediastinal adenopathy. From curve analysis, we decided the size criterion of lymph node to 1 cm in their short axis. Using this size criterion, it's sensitivity was 43.9%, specificity was 87.4%, and accuracy was 83.1%. Eventhough we couldn't determine the precise size criterion for the adenoca, it seemed that shorter than 1 cm size criterion should be applied in that particular cell type. Lymph node stations associated with the tuberculosis or bronchiectasis tend to be overestimated in nodal staging and have relatively high false positive rate. The low sensitivity of CT scan suggest that radical and complete dissection or precise mediastinal lymph node evaluation through the surgical approach is mandatory.
