Chen Chun, Lin Pei-Qiu, Lin Ruo-Bai, Kang Ming-Qiang, Zheng Wei, Chen Dao-Zhong
Department of Thoracic Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian, 350001, P. R. China.
Ai Zheng. 2007 Jun;26(6):657-60.
BACKGROUND & OBJECTIVE: It is still very difficult to make a definite diagnosis for some mediastinal diseases through some examinations, such as CT scan and fibrobronchoscopy. To judge the metastasis of mediastinal lymph nodes exactly for lung cancer patients and make proper staging of lung cancer are important for defining therapeutic schedule and estimating prognosis. This study was to explore the application value and summarize the experience of mediastinoscopy in the diagnosis of mediastinal diseases and the staging of lung cancer with enlarged mediastinal lymph nodes.
Mediastinoscopy and biopsy were performed in 16 patients with different mediastinal diseases detected by imaging examinations and 14 lung cancer patients with enlarged mediastinal lymph nodes diagnosed by CT scan, PET, or fibrobronchoscopy. The staging of lung cancer was identified according to pathologic diagnosis.
Of the 16 patients with different mediastinal diseases clarified by mediastinoscopy, 5 had nodule diseases, 3 had mediastinal lymph node tuberculosis, 2 had mediastinal lymphnoditis, 2 had lymphoma, 1 had extra-gastrointestinal type gastrointestinal malignant interstitialoma,1 had thymoma, 1 had metastatic small cell carcinoma, and 1 had metastatic adenocarcinoma. Of the 14 lung cancer patients with enlarged mediastinal lymph nodes, 6 had metastatic lymph nodes, and 8 had not; all of the 14 cases were accurately staged and received successful operations without severe postoperative complications.
Mediastinoscopy is a safe, accurate and effective procedure for the diagnosis of mediastinal diseases and the staging of lung cancer.
通过CT扫描、纤维支气管镜检查等手段对一些纵隔疾病进行明确诊断仍非常困难。准确判断肺癌患者纵隔淋巴结转移情况并对肺癌进行恰当分期，对于确定治疗方案和评估预后具有重要意义。本研究旨在探讨纵隔镜检查在纵隔疾病诊断及纵隔淋巴结肿大的肺癌分期中的应用价值，并总结经验。
对16例经影像学检查发现不同纵隔疾病的患者以及14例经CT扫描、PET或纤维支气管镜检查诊断为纵隔淋巴结肿大的肺癌患者进行纵隔镜检查及活检。根据病理诊断确定肺癌分期。
经纵隔镜检查明确诊断的16例不同纵隔疾病患者中，5例为结节病，3例为纵隔淋巴结结核，2例为纵隔淋巴结炎，2例为淋巴瘤，1例为胃肠道外型胃肠道恶性间质瘤，1例为胸腺瘤，1例为转移性小细胞癌，1例为转移性腺癌。14例纵隔淋巴结肿大的肺癌患者中，6例有淋巴结转移，8例无淋巴结转移；14例均准确分期并成功接受手术，术后无严重并发症。
纵隔镜检查是诊断纵隔疾病及肺癌分期的一种安全、准确且有效的方法。
