Bulut Sertan, Celik Deniz, Karamanlı Harun, Aktas Zafer, Özmen Özlem, Ertürk Hakan, Gürçay Nesrin, Biber Çiğdem
Department of Pulmonology, University of Health Sciences Atatürk Chest Diseases and Thoracic Surgery Education and Research Hospital, Ankara, TUR.
Department of Pulmonology, Alanya Alaaddin Keykubat University, Faculty of Health Sciences, Antalya, TUR.
Cureus. 2022 May 10;14(5):e24884. doi: 10.7759/cureus.24884. eCollection 2022 May.
Background Anthracosis may cause a positron emission tomography/computed tomography (PET/CT) false positivity in mediastinal and hilar lymph nodes. We aimed to evaluate the radiological features and the maximum standardized uptake values (SUVmax) of the mediastinal lymph nodes with anthracosis or squamous cell lung cancer metastasized. Methodology Patients diagnosed with anthracosis or squamous cell lung cancer with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) between January 1, 2015, and November 15, 2020, in a tertiary hospital were enrolled. The squamous cell subtype of lung cancer was selected due to its association with tobacco use, biomass, and air pollution. Anthracosis may occur due to the same etiologic reasons. Results A total of 190 patients met the study enrollment criteria, of which 86 were diagnosed with anthracosis and 33 with squamous cell lung cancer lymph metastasis. Median values for short axis, long axis, SUVmax, shape features, and presence of calcification were found significantly different between the groups. In receiver operating characteristic (ROC) analysis, the SUVmax cut-off value was calculated as 6.61. With this cutoff value, the negative predictive value (NPV) was 92.5% and the positive predictive value (PPV) was 54% for differentiating anthracosis and malignant lymph nodes metastasis. Conclusions We conclude that the evaluation of the shape and metabolic activities of the anthracotic lymph nodes detected by PET/CT together with EBUS-TBNA granted a more accurate staging of the patients and more cancer patients will benefit from surgical treatment.
背景 肺尘埃沉着病可能导致纵隔和肺门淋巴结在正电子发射断层扫描/计算机断层扫描（PET/CT）中出现假阳性。我们旨在评估肺尘埃沉着病或鳞状细胞肺癌转移所致纵隔淋巴结的放射学特征及最大标准化摄取值（SUVmax）。方法 纳入2015年1月1日至2020年11月15日在一家三级医院经支气管内超声引导下经支气管针吸活检（EBUS-TBNA）诊断为肺尘埃沉着病或鳞状细胞肺癌的患者。选择肺癌的鳞状细胞亚型是因其与烟草使用、生物质和空气污染有关。肺尘埃沉着病可能由相同的病因引起。结果 共有190例患者符合研究纳入标准，其中86例诊断为肺尘埃沉着病，33例诊断为鳞状细胞肺癌淋巴结转移。发现两组之间短轴、长轴、SUVmax、形态特征和钙化情况的中位数存在显著差异。在受试者工作特征（ROC）分析中，SUVmax的截断值计算为6.61。以此截断值区分肺尘埃沉着病和恶性淋巴结转移时，阴性预测值（NPV）为92.5%，阳性预测值（PPV）为54%。结论 我们得出结论，PET/CT联合EBUS-TBNA对检测到的肺尘埃沉着病淋巴结的形态和代谢活性进行评估，能更准确地对患者进行分期，更多癌症患者将从手术治疗中获益。
