Gross B H, Glazer G M, Orringer M B, Spizarny D L, Flint A
Department of Radiology, University of Michigan Medical Center, Ann Arbor.
Radiology. 1988 Jan;166(1 Pt 1):71-4. doi: 10.1148/radiology.166.1.3336704.
CT staging of mediastinal lymph node metastases from bronchogenic carcinoma is a subject of considerable controversy. The frequency of metastases to normal-sized lymph nodes is a critical issue related to the sensitivity of CT. The authors prospectively examined 42 patients with bronchogenic carcinoma with CT; in 39, careful surgical-pathologic correlation of mediastinal lymph node status was possible. Only 7% had metastases limited to mediastinal lymph nodes that were normal-sized at CT. This reflected a low overall frequency of metastases to normal-sized nodes and several diagnostic factors that converted potentially false-negative studies into true-positive CT studies. In this small series, metastases to enlarged nodes were more likely to have extracapsular spread of tumor, a poor prognostic factor. Overall, the authors do not consider metastases to normal-sized mediastinal lymph nodes to be a major problem in CT staging of non-small cell lung cancer.
支气管源性癌纵隔淋巴结转移的CT分期是一个颇具争议的话题。转移至正常大小淋巴结的频率是与CT敏感性相关的关键问题。作者对42例支气管源性癌患者进行了CT前瞻性检查；其中39例患者的纵隔淋巴结状态能够进行细致的手术病理对照。仅有7%的患者转移局限于CT显示为正常大小的纵隔淋巴结。这反映出转移至正常大小淋巴结的总体频率较低，以及一些将潜在假阴性研究转变为真阳性CT研究的诊断因素。在这个小样本系列中，转移至肿大淋巴结的情况更有可能出现肿瘤包膜外扩散，这是一个不良预后因素。总体而言，作者认为转移至正常大小的纵隔淋巴结在非小细胞肺癌的CT分期中并非主要问题。
