Potepan P, Meroni E, Spagnoli I, Milella M, Danesini G M, Laffranchi A, Civelli E, Alloisio M, Mariani L, Spinelli P, Guzzon A
Department of Diagnostic Radiology, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy.
Eur Radiol. 1996;6(1):19-24. doi: 10.1007/BF00619947.
In this prospective study endoscopic ultrasound (EUS) and computed tomography (CT) were evaluated to compare diagnostic accuracy of the two methods. They were performed for nodal staging in selected patients admitted to our institution for non-small-cell lung cancer (NSCLC). From February 1992 to July 1993, 45 patients were recruited for the study when N3 and N2 nodal involvement were excluded on standard chest X-ray. All the patients completed EUS and CT exams for staging before treatment. The results of sensitivity, specificity and accuracy were obtained in 30 patients who underwent surgical treatment with macroscopically radical resection of T and N, which allowed a complete surgical and histological comparison of CT and EUS findings. On a per-patient basis CT results were: sensitivity 63.6%, specificity 78.9% and accuracy of 73.3%; on a nodal station basis sensitivity, specificity and accuracy were 70.0%, 85.1% and 81.6%, respectively. The EUS evaluation showed, on a per-patient basis, values of sensitivity 45.5%, specificity 57.9% and overall diagnostic accuracy of 53.3%. On a nodal station basis the results were 50.0%, 86.6% and 78.2%, respectively. The results obtained in the 30 patients when both techniques were taken in association regarding sensitivity (90.9%), specificity (73.7%) and accuracy (80.0%) on a per-patient basis suggest that the association of EUS and CT offers the best approach for preoperative staging of NSCLC.
在这项前瞻性研究中，对内镜超声（EUS）和计算机断层扫描（CT）进行了评估，以比较这两种方法的诊断准确性。它们用于对因非小细胞肺癌（NSCLC）入住我院的选定患者进行淋巴结分期。从1992年2月至1993年7月，招募了45例患者进行研究，这些患者在标准胸部X线检查中排除了N3和N2淋巴结受累情况。所有患者在治疗前均完成了EUS和CT分期检查。30例接受了T和N宏观根治性切除手术治疗的患者获得了敏感性、特异性和准确性结果，这使得能够对CT和EUS检查结果进行完整的手术和组织学比较。以患者为基础，CT结果为：敏感性63.6%，特异性78.9%，准确性73.3%；以淋巴结站为基础，敏感性、特异性和准确性分别为70.0%、85.1%和81.6%。EUS评估显示，以患者为基础，敏感性值为45.5%，特异性为57.9%，总体诊断准确性为53.3%。以淋巴结站为基础，结果分别为50.0%、86.6%和78.2%。在30例患者中，当两种技术联合使用时，以患者为基础的敏感性（90.9%）、特异性（73.7%）和准确性（80.0%）结果表明，EUS和CT联合使用为NSCLC术前分期提供了最佳方法。
