Evaluation of Mediastinal Lymph Node Metastasis in Lung Cancer: Factors influencing the Diagnostic Accuracy ofCT
Journal of the Korean Radiological Society
;
: 445-451, 1998.
Artigo
em Coreano
| 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.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Pneumonia
/
Vértebra Cervical Áxis
/
Carcinoma de Células Escamosas
/
Adenocarcinoma
/
Tomografia Computadorizada por Raios X
/
Estudos Retrospectivos
/
Sensibilidade e Especificidade
/
Carcinoma Pulmonar de Células não Pequenas
/
Pulmão
/
Neoplasias Pulmonares
Tipo de estudo:
Estudo diagnóstico
/
Estudo observacional
/
Estudo prognóstico
Limite:
Humanos
Idioma:
Coreano
Revista:
Journal of the Korean Radiological Society
Ano de publicação:
1998
Tipo de documento:
Artigo
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