Clinic of Thoracic Surgery, Maria Hilf Hospital, Mönchengladbach, Germany; Department of Special Surgery, Medical University of Plovdiv, Plovdiv, Bulgaria.
Lung Cancer Center, Bremen East Clinic, University of Bremen, Bremen, Germany.
Ann Afr Med. 2023 Jan-Mar;22(1):101-106. doi: 10.4103/aam.aam_12_22.
The tumor involvement of lymph nodes (LN) in N2 station is a very important factor for the further therapy decision and the prognosis of lung cancer patients. Today, integrated positron emission tomography-computed tomography (PET-CT) is considered to be the new standard in the staging of bronchial carcinoma. The aim of this study is to investigate the correctness of the clinical staging of the mediastinal LNs in operated patients and to investigate the sensitivity and specificity of the PET-CT examination for mediastinal LNs.
In the years 2010-2014, 359 patients underwent surgery for bronchial carcinoma. The histological examination of all mediastinal and hilar LNs was used as a reference to the data from the PET-CT examinations. The correctness of the PET staging, overestimation, and underestimation for the N stage was analyzed. In addition, the "sensitivity," "specificity," and "overall accuracy" of the PET-CT examination with regard to the N2 LNs were calculated.
It was found that in 8.9% the staging of the mediastinal N2/N3 LN stations was rated too high by the PET and in 11.2% too low. The study showed a sensitivity of 47.37%, a specificity of 90.07%, and an accuracy of 81.01% for the mediastinal LNs.
Our study confirms the limited ability of integrated PET-CT in staging the mediastinal LNs. We, therefore, recommend a histological examination of the LNs in patients with PET-positive N2 LNs to avoid false-positive results and to initiate correct therapy.
淋巴结（LN）在 N2 站的肿瘤累及是肺癌患者进一步治疗决策和预后的一个非常重要的因素。如今，正电子发射断层扫描-计算机断层扫描（PET-CT）被认为是支气管癌分期的新标准。本研究旨在探讨手术患者纵隔 LN 临床分期的正确性，并探讨 PET-CT 检查对纵隔 LN 的敏感性和特异性。
2010 年至 2014 年间，359 例患者因支气管癌接受手术治疗。所有纵隔和肺门淋巴结的组织学检查均作为参考，与 PET-CT 检查数据进行比较。分析了 PET 分期、高估和低估 N 期的正确性。此外，还计算了 PET-CT 检查对 N2 淋巴结的“敏感性”、“特异性”和“总准确率”。
发现 8.9%的纵隔 N2/N3 淋巴结分期被 PET 高估，11.2%被低估。研究显示纵隔淋巴结的敏感性为 47.37%，特异性为 90.07%，准确性为 81.01%。
本研究证实了集成 PET-CT 在纵隔淋巴结分期方面的能力有限。因此，我们建议对 PET 阳性 N2 淋巴结患者进行淋巴结组织学检查，以避免假阳性结果并启动正确的治疗。
