Wang Xin, Huang Zhifan, Rong Tiehua, Wu Qiuliang, Liang Xiaoman, Yang Mingtian, Ceng Canguang, Long Hao, Lin Peng, Fu Jianhua
Department of Thoracic Surgery, Sun Yet-Sen University of Medical Sciences, Cancer Center, Guangzhou 510060, China.
Zhonghua Zhong Liu Za Zhi. 2002 Jan;24(1):74-6.
To evaluate the value of mediastinoscopy in diagnosing unknown mediastinal disease and staging of lung cancers.
From October 2000 to August 2001, 41 patients were examined by cervical mediastinoscopy with or without anterior mediastinotomy for diagnostic and staging purposes. Of these 41 patients, 12 were for diagnosis of unknown mediastinal disease, 3 for diagnosis and staging of pulmonary nodule or mass clinically suspected to be malignancy and 26 for the staging of lung cancer.
Ten of 12 patients with unknown mediastinal disease were diagnosed pathologically as thymoma in 1, metastatic lesion from lung cancer in 1, metastatic thyroid carcinoma in 1, lymph node hyperplasia in 1, teratoma in 1, sarcoidosis in 1, inflammatory pseudotumor in 1 and tuberculosis in 3, giving a diagnostic rate of 83.3%. Of three patients with suspected malignancy, one was diagnosed as tuberculosis by cervical mediastinoscopy and the other two as lymphoma and pulmonary inflammatory pseudotumor by thoracoscopy and thoracotomy. The sensitivity and specificity of mediastinoscopy for the staging of mediastinal nodes in 26 lung cancers were 87.5% and 100%. Only one wound infection but no other major complication was found.
Mediastinoscopy is a safe procedure which can accurately provide information on diagnosis and staging.
评估纵隔镜检查在诊断不明纵隔疾病及肺癌分期中的价值。
2000年10月至2001年8月，41例患者接受了颈部纵隔镜检查，部分患者同时行前纵隔切开术，用于诊断和分期。这41例患者中，12例用于诊断不明纵隔疾病，3例用于诊断和分期临床怀疑为恶性的肺结节或肿块，26例用于肺癌分期。
12例不明纵隔疾病患者中，10例经病理诊断为胸腺瘤1例、肺癌转移灶1例、甲状腺癌转移1例、淋巴结增生1例、畸胎瘤1例、结节病1例、炎性假瘤1例、结核3例，诊断率为83.3%。3例疑似恶性肿瘤患者中，1例经颈部纵隔镜检查诊断为结核，另外2例经胸腔镜和开胸手术诊断为淋巴瘤和肺炎性假瘤。纵隔镜检查对26例肺癌纵隔淋巴结分期的敏感性和特异性分别为87.5%和100%。仅发现1例伤口感染，无其他严重并发症。
纵隔镜检查是一种安全的检查方法，能够准确提供诊断和分期信息。
