Ikezoe J, Kadowaki K, Morimoto S, Takashima S, Kozuka T, Nakahara K, Kuwahara O, Takeuchi N, Yasumitsu T, Nakano N
Department of Radiology, Osaka University Medical School, Japan.
J Comput Assist Tomogr. 1990 May-Jun;14(3):340-4. doi: 10.1097/00004728-199005000-00003.
We evaluated the sensitivity of CT for detecting mediastinal lymph node metastases in patients with nonsmall cell bronchogenic carcinoma. Computed tomography of 208 cases of surgically proven bronchogenic carcinoma from three institutes was evaluated retrospectively using specific diagnostic criteria. These consisted of two size thresholds for specific mediastinal node regions: 13 mm short transverse diameter for nodes in the subcarinal, precarinal, and tracheobronchial regions and 10 mm for other regions. Based on these criteria, the overall sensitivity of CT was 69%, specificity 94%, and accuracy 86% for detection of metastasis. In cases of adenocarcinoma, sensitivity was 61%, specificity 93%, and accuracy 81%, and in those of squamous cell carcinoma the respective values were 86, 94, and 92%. Comparison between the results using the present criteria with the former criterion of 10 mm short transverse diameter for all mediastinal nodes revealed that the number of false-positive cases decreased markedly. We conclude that more accurate CT evaluation of mediastinal lymph node metastasis in nonsmall cell bronchogenic carcinoma can be achieved with specific size criteria for specific mediastinal regions.
我们评估了CT检测非小细胞支气管肺癌患者纵隔淋巴结转移的敏感性。回顾性分析了来自三个机构的208例经手术证实的支气管肺癌患者的计算机断层扫描结果，采用特定的诊断标准进行评估。这些标准包括特定纵隔淋巴结区域的两个大小阈值：隆突下、气管前和气管支气管区域的淋巴结短横径为13mm，其他区域为10mm。基于这些标准，CT检测转移的总体敏感性为69%，特异性为94%，准确性为86%。在腺癌病例中，敏感性为61%，特异性为93%，准确性为81%；在鳞状细胞癌病例中，相应的值分别为86%、94%和92%。将使用当前标准的结果与之前所有纵隔淋巴结短横径为10mm的标准进行比较，发现假阳性病例数量明显减少。我们得出结论，通过针对特定纵隔区域的特定大小标准，可以更准确地对非小细胞支气管肺癌的纵隔淋巴结转移进行CT评估。
