Ferguson M K, MacMahon H, Little A G, Golomb H M, Hoffman P C, Skinner D B
J Thorac Cardiovasc Surg. 1986 Apr;91(4):498-504.
To determine the regional accuracy of computed tomography of the mediastinum in staging lung cancer, we compared the results of preoperative computed tomographic staging to pathologic findings in lymph nodes taken at mediastinoscopy and/or thoracotomy in 61 patients. Twenty-two patients had adenocarcinoma, 24 had squamous cell carcinoma, eight had large cell tumors, and seven had small cell cancer or mixed cellular types. Sixteen patients had Stage I, eight had Stage II, and 37 had Stage III disease. Thirteen patients had mediastinoscopy only, and the remaining 48 patients had thoracotomy. Computed tomographic staging of the mediastinum as a whole had an accuracy of 88% with a negative predictive index of 96.1%. In examining the differential regional accuracy within the mediastinum we found results in the aortopulmonary window to be inferior to those of other regions, with an accuracy of 80% and a negative predictive index of 83.3%. The reliability of computed tomographic scan staging varied relative to cell type. The accuracy rate in adenocarcinoma was 94.7% compared to 70.6% in squamous cell carcinoma. Computed tomography is accurate for staging the mediastinum in lung cancer, and this accuracy holds over the regions of the mediastinum except the aortopulmonary window. Computed tomography is more accurate for staging adenocarcinoma than squamous cell cancer.
为了确定纵隔计算机断层扫描在肺癌分期中的区域准确性，我们将61例患者术前计算机断层扫描分期结果与经纵隔镜检查和/或开胸手术获取的淋巴结病理结果进行了比较。22例患者为腺癌，24例为鳞状细胞癌，8例为大细胞肿瘤，7例为小细胞癌或混合细胞类型。16例患者为I期，8例为II期，37例为III期疾病。13例患者仅接受了纵隔镜检查，其余48例患者接受了开胸手术。整个纵隔的计算机断层扫描分期准确率为88%，阴性预测指数为96.1%。在检查纵隔内不同区域的准确性时，我们发现主肺动脉窗的结果不如其他区域，准确率为80%，阴性预测指数为83.3%。计算机断层扫描分期的可靠性因细胞类型而异。腺癌的准确率为94.7%，而鳞状细胞癌为70.6%。计算机断层扫描对肺癌纵隔分期是准确的，除主肺动脉窗外，这种准确性在纵隔各区域均成立。计算机断层扫描对腺癌分期比对鳞状细胞癌更准确。
