Matthews J I, Richey H M, Helsel R A, Grishkin B A
Arch Intern Med. 1987 Mar;147(3):449-53.
One hundred seventy-four patients with bronchogenic carcinoma underwent computed tomography (CT) as part of their preoperative evaluation. Overall, CT had a sensitivity of 86%, a specificity of 78%, and an accuracy of 81% in identifying mediastinal lymph node metastases. In patients with a central tumor, the sensitivity was 93%, the specificity 74%, and the accuracy 83%. In patients with a peripheral tumor, the respective percentages were 55%, 82%, and 77%. Only 11 of 66 patients with a peripheral tumor had mediastinal metastases, and five of these patients had a normal CT scan. Conversely, 43 of 64 patients with a central tumor and mediastinal lymph node enlargement on the CT scan had unresectable disease, compared with only one of 44 patients without such enlargement. We conclude that CT is not useful in the evaluation of patients with a peripheral tumor; however, it is useful in determining which patients with a central tumor do not require a surgical staging procedure prior to thoracotomy.
174例支气管癌患者在术前评估中接受了计算机断层扫描（CT）检查。总体而言，CT在识别纵隔淋巴结转移方面的敏感性为86%，特异性为78%，准确性为81%。在中央型肿瘤患者中，敏感性为93%，特异性为74%，准确性为83%。在周围型肿瘤患者中，相应的百分比分别为55%、82%和77%。66例周围型肿瘤患者中只有11例有纵隔转移，其中5例CT扫描正常。相反，CT扫描显示中央型肿瘤且纵隔淋巴结肿大的64例患者中有43例患有不可切除的疾病，而在没有这种肿大的44例患者中只有1例。我们得出结论，CT对周围型肿瘤患者的评估无用；然而，它有助于确定哪些中央型肿瘤患者在开胸手术前不需要进行手术分期程序。
