Kusajima Y, Hirono T
Department of Chest Surgery, Toyama Shimin Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1991 Jul;39(7):1032-8.
The size of lymph node is one of the most important factor in evaluation of lymph node metastasis in lung cancer. The most appropriate size for detecting lung cancer lymph node metastasis was studied by 2403 dissected lymph nodes in 75 operated cases of lung cancer. From the result of Receiver Operating Characteristic (ROC) curve analysis, long-axis diameter of the lymph node showed higher accuracy of diagnosis of metastasis than short-axis diameter. Metastasis of squamous cell carcinoma was diagnosed more accurately than that of adenocarcinoma. The most adequate threshold for detection of metastasis in squamous cell carcinoma was 10 mm in long-axis diameter with sensitivity of 73.8% and specificity of 78%. On the other hand, that of adenocarcinoma was 7 mm in long-axis diameter with sensitivity of 65.7% and specificity of 55.9%. That threshold value of adenocarcinoma was approximate to the value of normal lymph node size in the mediastinum. It was suggested that the size for detection of lymph node metastasis was depended upon histological type, and detection of lymph node metastasis in adenocarcinoma was extremely difficult.
淋巴结大小是评估肺癌淋巴结转移的最重要因素之一。通过对75例肺癌手术病例中2403个切除的淋巴结进行研究，探讨了检测肺癌淋巴结转移的最合适大小。根据受试者工作特征（ROC）曲线分析结果，淋巴结的长径对转移诊断的准确性高于短径。鳞状细胞癌转移的诊断比腺癌更准确。鳞状细胞癌转移检测的最适阈值为长径10mm，敏感性为73.8%，特异性为78%。另一方面，腺癌的阈值为长径7mm，敏感性为65.7%，特异性为55.9%。腺癌的该阈值接近纵隔正常淋巴结大小的值。提示淋巴结转移的检测大小取决于组织学类型，腺癌淋巴结转移的检测极其困难。
