Scott I R, Müller N L, Miller R R, Evans K G, Nelems B
Department of Radiology, Vancouver General Hospital, British Columbia, Canada.
Radiology. 1988 Jan;166(1 Pt 1):75-9. doi: 10.1148/radiology.166.1.3336705.
The new International Staging System identifies a subset of patients with stage III lung cancer who have improved survival rates after surgical resection. The computed tomographic (CT), surgical, and pathologic findings in 26 patients with completely resected stage IIIa lung cancer were reviewed. Preoperative CT scans accurately demonstrated chest wall invasion in only two of ten patients with chest wall or diaphragmatic invasion. CT demonstrated pericardial involvement in only one of three patients. Tumor extension to within 2 cm of the tracheal carina was seen with CT in one of three patients. Eleven of 26 patients had limited ipsilateral mediastinal (N2) disease; eight of 11 had affected nodes greater then 10 mm on CT scans. As previously shown, CT is of limited value in the assessment of chest wall, mediastinal, pleural, or pericardial tumor extension; however, such extension does not preclude complete resection. Ipsilateral node involvement does not preclude surgery. Familiarity with the new staging system and awareness of what constitutes potentially resectable disease are necessary for an adequate assessment of CT findings.
新的国际分期系统确定了一部分III期肺癌患者，他们在手术切除后生存率有所提高。回顾了26例完全切除的IIIa期肺癌患者的计算机断层扫描（CT）、手术和病理结果。术前CT扫描仅在10例有胸壁或膈肌侵犯的患者中的2例准确显示了胸壁侵犯。CT仅在3例患者中的1例显示心包受累。3例患者中的1例CT显示肿瘤延伸至气管隆突2厘米范围内。26例患者中有11例有局限性同侧纵隔（N2）疾病；11例中的8例在CT扫描上有大于10毫米的受累淋巴结。如先前所示，CT在评估胸壁、纵隔、胸膜或心包肿瘤延伸方面价值有限；然而，这种延伸并不排除完全切除。同侧淋巴结受累并不排除手术。熟悉新的分期系统并了解哪些构成潜在可切除疾病对于充分评估CT结果是必要的。
