Kendirlinan Resat, Ozkan Gülcihan, Bayram Mehmet, Bakan Nur Dilek, Tutar Mehmet, Gür Aygün, Camsari Güngör
Sivas Numune Hospital, Department for Chest Diseases, Sivas, Turkey.
Multidiscip Respir Med. 2011 Aug 31;6(4):220-5. doi: 10.1186/2049-6958-6-4-220.
To assess frequency and significance of enlarged nonpalpable supraclavicular lymph nodes with routine ultrasound (US) evaluation and US-guided fineneedle aspiration biopsy (FNAB) for the diagnosis and staging of patients with lung cancer.
106 consecutive patients with lung cancer and nonpalpable supraclavicular lymph nodes were evaluated with cervical US for the presence of pathological lymph nodes. FNAB was performed in patients with nodes with short-axis > 5 mm, rounded shape and missing echogenic hilum.
27 (25.5%) patients had enlarged supraclavicular lymph nodes on US. Fourteen patients (13.2%) had cytologically proven lymph node involvement. Supraclavicular lymph node metastasis was more frequent in patients with mediastinal invasion (p = 0.0001) and patients with enlarged lymph nodes on upper paratracheal stations on thorax CT (p = 0.0001). No relation was found between supraclavicular lymph node involvement and T stage (p = 0.27), distant metastasis (p = 0.50) or histological type (p = 0.80). Three patients were upstaged from IIIA to IIIB status. US-guided FNAB was the only diagnostic method in 2 patients.
US-guided FNAB is a simple and safe procedure which can document N3 stage of disease in lung cancer patients. Thereby more invasive and expensive diagnostic procedures can be avoided in selected lung cancer patients.
通过常规超声（US）评估及超声引导下细针穿刺活检（FNAB），评估不可触及的锁骨上淋巴结肿大在肺癌患者诊断及分期中的频率和意义。
对106例连续的肺癌且锁骨上淋巴结不可触及的患者进行颈部超声检查，以确定是否存在病理性淋巴结。对短轴>5mm、呈圆形且无高回声 hilum的淋巴结患者进行FNAB。
27例（25.5%）患者超声显示锁骨上淋巴结肿大。14例（13.2%）患者经细胞学证实有淋巴结受累。纵隔侵犯患者（p = 0.0001）及胸部CT上气管旁上组淋巴结肿大的患者（p = 0.0001）锁骨上淋巴结转移更常见。未发现锁骨上淋巴结受累与T分期（p = 0.27）、远处转移（p = 0.50）或组织学类型（p = 0.80）之间存在关联。3例患者分期从IIIA期上调至IIIB期。超声引导下FNAB是2例患者的唯一诊断方法。
超声引导下FNAB是一种简单、安全的检查方法，可确定肺癌患者的N3期疾病。从而可避免在部分肺癌患者中采用更具侵入性且昂贵的诊断方法。
