Wang Jiandong, Sun Yu'e, Wang Zhiqiang, Wang Xiangdong
Department of Thoracic Surgery, General Hospital of People's Liberation Army, Beijing 100853, China.
Zhonghua Wai Ke Za Zhi. 2002 Aug;40(8):577-80.
To calculate the rate of detection for mediastinal lymph nodes and to set up a criteria for the diagnosis of metastatic mediastinal lymph nodes in lung neoplasm by means of endoscopic ultrasonography (EUS).
In 21 patients with lung cancer who underwent preoperative EUS on mediastinal lymph nodes, 103 lymph nodes detected by EUS were resected and confirmed pathologically all. The difference between benign and malignant lymph nodes was analysed statistically.
The rates of metastatic lymph nodes detected by EUS were significantly higher than these of non-metastatic lymph nodes (chi(2) = 11.752, P = 0.01) in levels 5, 7, 8, and 9 of mediastinal lymph node staging map (Union Internationale Contre le Cancer, 1997). The mean long and short axis of metastatic lymph nodes were significantly longer than those of non-metastatic lymph nodes (short axis: t = 4.541, P = 0.000; long axis: t = 3.278, P = 0.002). Metastatic lymph nodes showed some characteristic ultrasonographic features, including short axis >/= 1.0 cm, long axis >/= 1.5 cm, and clear boundary. According to the equation P((1)) = 1/[1 + e(-(-2.963 + 2.041 X1 + 1.681 X2))], the lymph nodes were assumed to be malignant when P((1)) >/= 0.5. The accuracy, sensitivity, specificity of this methods were 72.8%, 72.7%, 72.9% respectively, and were superior to those of CT for the same nods in levels 5, 7, 8 and 9 (chi(2) = 6.812, P = 0.013).
EUS is an effective method of diagnostic evaluation of mediastinal lymph nodes of lung cancer.
通过内镜超声检查（EUS）计算纵隔淋巴结的检出率，并建立肺癌纵隔淋巴结转移的诊断标准。
对21例肺癌患者术前行纵隔淋巴结EUS检查，将EUS检出的103枚淋巴结全部切除并进行病理确诊，对良恶性淋巴结的差异进行统计学分析。
在纵隔淋巴结分期图谱（国际抗癌联盟，1997年）的5、7、8和9区，EUS检测到的转移淋巴结率显著高于非转移淋巴结率（χ² = 11.752，P = 0.01）。转移淋巴结的平均长短径明显长于非转移淋巴结（短径：t = 4.541，P = 0.000；长径：t = 3.278，P = 0.002）。转移淋巴结表现出一些特征性超声表现，包括短径≥1.0 cm，长径≥1.5 cm，边界清晰。根据公式P(1) = 1/[1 + e^(-(-2.963 + 2.041X1 + 1.681X2))]，当P(1)≥0.5时，淋巴结被认为是恶性的。该方法的准确性、敏感性、特异性分别为72.8%、72.7%、72.9%，在5、7、8和9区对相同淋巴结的诊断优于CT（χ² = 6.812，P = 0.013）。
EUS是诊断评估肺癌纵隔淋巴结的有效方法。
