Würsten H U, Vock P
Clinic of Thoracic and Cardiovascular Surgery, University of Bern, Switzerland.
Thorac Cardiovasc Surg. 1987 Dec;35(6):355-60. doi: 10.1055/s-2007-1020263.
The value of computed tomography (CT) in predicting direct mediastinal infiltration of stage T4N0-1 lung carcinoma was evaluated prospectively in 11 patients with surgical and histological proof. Furthermore, its role in twelve non-operated patients was assessed retrospectively. The radiologic signs detected independently by two radiologists correlated in 90%. Mediastinal infiltration was verified in 7 of 11 patients (63%). Only in 3 out of the 12 patients treated non-surgically was CT the only criterium for inoperability. In all other patients additional findings, such as scintigraphy, radiologic or bioptic proof of distant metastases, supported inoperability. The limited specificity of CT (63%) demands aggressive staging procedures before any patient is excluded from surgery, the only potentially curative treatment.
前瞻性评估了计算机断层扫描（CT）在预测T4N0-1期肺癌直接纵隔浸润方面的价值，研究对象为11例有手术及组织学证据的患者。此外，回顾性评估了CT在12例未接受手术患者中的作用。两位放射科医生独立检测到的放射学征象一致性为90%。11例患者中有7例（63%）证实存在纵隔浸润。在12例非手术治疗的患者中，只有3例患者CT是判断不可手术的唯一标准。在所有其他患者中，其他检查结果，如闪烁扫描、远处转移的放射学或活检证据，支持不可手术的判断。CT的特异性有限（63%），这就要求在任何患者被排除手术（唯一可能治愈的治疗方法）之前，都要采取积极的分期检查程序。
