Evaluation of Mediastinal Lymph Node Metastasis in Lung Cancer: Factors influencing the Diagnostic Accuracy ofCT
Journal of the Korean Radiological Society
;
: 445-451, 1998.
Article
in Korean
| WPRIM
| ID: wpr-51139
ABSTRACT
PURPOSE:
To evaluate factors influencing the CT assessment of mediastinal lymph node metastasis in patientswith non-small cell lung cancer. MATERIALS ANDMETHODS:
CT scans of 198 patients who had undergone thoracotomyand mediastinal lymph node dissection for non-small cell lung cancer were retrospectively evaluated using a sizecriterion of > or = 10mm in the short axis. To evaluate the accuracy of CT in diagnosing lymph node metastasis on anodal station-by-station basis, CT and pathological results were correlated. Analysis included a comparison of thesensitivity and specificity of CT according to 1) cell type of tumor, squamous cell carcinoma versusadenocarcinoma (excluding bronchioloalveolar cell carcinoma) ; 2) histologic differentiation;3) tumor size;4)central and peripheral of the tumor;5) the presence or absence of obstructive pneumonitis and/or atelectasis;6)the presence or absence of prior granulomatous disease.RESULTS:
The overall sensitivity, Specificity, positive predictive value, and negative predictive value of CT in diagnosing mediastinal lymph node metastasis were 65%,84%, 43%, and 93%, respectively. Sensitivity for squamous cell carcinoma (72%) was significantly higher than thatfor adenocarcinoma(44%)(p<0.01). Higher specificities were noted in patients without obstructive pneumonitisand/or atelectasis(91% versus 75%)(P<0.01), and with a peripherally located tumor (90% versus 82%)(P<0.01).sensitivity and specificity were not appreciably altered by other variables.CONCLUSION:
In the CT assessment ofmediastinal lymph node metastasis the cell type of adenocarcinoma adversely affected sensitivity, with a highfrequency of normal-sized metastatic nodes. Obstructive pneumonitis caused by central tumor adversely affectedspecificity with the frequent occurrence of hyperplastc nodes.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pneumonia
/
Axis, Cervical Vertebra
/
Carcinoma, Squamous Cell
/
Adenocarcinoma
/
Tomography, X-Ray Computed
/
Retrospective Studies
/
Sensitivity and Specificity
/
Carcinoma, Non-Small-Cell Lung
/
Lung
/
Lung Neoplasms
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
Limits:
Humans
Language:
Korean
Journal:
Journal of the Korean Radiological Society
Year:
1998
Type:
Article
Similar
MEDLINE
...
LILACS
LIS