van Beek F T, Maas K W, Timmer R, Seldenrijk C A, de Bruin P C, Schramel F M N H
St. Antonius Ziekenhuis, Postbus 2500, 3430 EM Nieuwegein.
Ned Tijdschr Geneeskd. 2006 Jan 21;150(3):144-50.
To calculate the number of cervical mediastinoscopies that need not be carried out ifoesophageal endoscopic ultrasound and fine-needle aspiration biopsy (EUS-FNA) are included in the staging of patients with non-small-cell lung carcinoma (NSCLC).
Retrospective, descriptive.
Patients referred to the St. Antonius Hospital in Nieuwegein, the Netherlands, with NSCLC from January to December 2003 routinely underwent EUS-FNA during the staging process. If mediastinal or distant metastases were found to be present then cervical mediastinoscopy was not carried out as the patient was not eligible for operation. If no metastases were demonstrated then cervical mediastinoscopy was carried out. The value of EUS-FNA was calculated.
A total of 43 patients underwent EUS-FNA: 32 men and 11 women with an average age of 64 (range: 45-77). In 22 (51%) of them, cervical mediastinoscopy was not performed as EUS-FNA demonstrated malignant cells in the lymph nodes of the mediastinum or abdomen, in the left adrenal gland or in the primary tumour which had grown into the mediastinum. In 2 of the 21 other patients malignant cells were found on mediastinoscopy showing the EUS-FNA results in 2 of 43 patients (5%) to be false-negative. No complications occurred.
Based on the findings from EUS-FNA, cervical mediastinoscopy was not performed in 51% of the patient group.
计算在非小细胞肺癌(NSCLC)患者分期中纳入食管内镜超声和细针穿刺活检(EUS-FNA)后无需进行的颈部纵隔镜检查的数量。
回顾性、描述性研究。
2003年1月至12月转诊至荷兰尼乌韦根圣安东尼医院的NSCLC患者在分期过程中常规接受EUS-FNA检查。如果发现存在纵隔或远处转移,则不进行颈部纵隔镜检查,因为患者不符合手术条件。如果未发现转移,则进行颈部纵隔镜检查。计算EUS-FNA的价值。
共有43例患者接受了EUS-FNA检查:32例男性和11例女性,平均年龄64岁(范围:45 - 77岁)。其中22例(51%)未进行颈部纵隔镜检查,因为EUS-FNA在纵隔或腹部淋巴结、左肾上腺或侵犯纵隔的原发性肿瘤中发现了恶性细胞。在其他21例患者中的2例纵隔镜检查发现了恶性细胞,表明43例患者中有2例(5%)的EUS-FNA结果为假阴性。未发生并发症。
基于EUS-FNA的结果,51%的患者组未进行颈部纵隔镜检查。