Diagnostic Value of Multi-slice Spiral CT in Non-small Cell Lung Cancer Preoperative TNM Staging / 中国医学影像学杂志

ABSTRACT

PurposeTo evaluate the diagnostic value of multi-slice spiral CT (MSCT) in preoperative TNM staging in non-small cell lung cancer (NSCLC) by comparing with corresponding postoperative pathology.Materials and Methods Ninety-two cases of surgically resected lung cancer were included. Clinical and pathological staging were made and compared, and to evaluate the sensitivity, specificity and accuracy of the MSCT in diagnosing lymph node metastasis.Results MSCT made correct T staging in 83.7% of the cases with excellent agreement (Kappa=0.727,P<0.05). Accurate N staging was in 79.3% of the patients with acceptable agreement (Kappa=0.635,P<0.05). The TNM staging was 75.0% accurate with moderate agreement (Kappa=0.680,P<0.05). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT in diagnosis of lymph node metastasis were 71.1%, 85.2%, 77.1%, 80.7% and 79.3%, respectively. CT accuracy in the diagnosis of groups 4, 5, 6, 10 lymph nodes metastasis was relatively low, in which group 4 had highest false positive, and group 10 had the highest false negative.Conclusion The TNM staging of NSCLC based on MSCT scan is valuable. It can be used as the main basis to evaluate the patient's ability to choose the best treatment plan and predict the prognosis.