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首页> 外文期刊>Thoracic cancer. >Occult mediastinal lymph node metastasis in FDG‐PET/CT node‐negative lung adenocarcinoma patients: Risk factors and histopathological study
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Occult mediastinal lymph node metastasis in FDG‐PET/CT node‐negative lung adenocarcinoma patients: Risk factors and histopathological study

机译：FDG-PET / CT节点阴性肺腺癌患者中潜水综合淋巴结转移：危险因素和组织病理学研究

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The aim of this study was to investigate predictive factors of occult mediastinal lymph node metastasis (MLNM) in preoperative 18 F-fluorodeoxy-glucose PET/CT node-negative lung adenocarcinoma patients. We reviewed the clinical data and PET/CT parameters of 360 consecutive pulmonary adenocarcinoma patients who were scheduled to undergo anatomical pulmonary resection and systemic mediastinal node dissection. The nodal metastasis was pathologically defined and all resected tumors were classified according to the 2011 IASLC/ATS/ERS classification. Univariate and multivariate analysis were conducted to evaluate the associations between clinicopathological variables and MLNM. Of all 360 patients, 54 (15.0%) had pathological N2 diseases. The serum CEA level, nodule type, hilar nodal SUVmax, tumor SUVmax, size, location and histologic subtype were associated with MLNM significantly on univariate analysis. On multivariate analysis, CEA?≥?5.0 ng/mL (P??0.001), solid nodule (P = 0.012), tumor SUVmax?≥?3.7 (P??0.027), hilar nodal SUVmax?≥?2.0 (P??0.001) and centrally located tumor (P = 0.035) were independent risk factors for MLNM. The area under the ROC curve (AUC) for tumor SUVmax and hilar nodal SUVmax in predicting MLNM was 0.764 and 0.730, respectively, and the combined use of five factors yielded a higher AUC of 0.885. Increased primary tumor and hilar lymph node SUVmax, solid nodule, centrally located tumor and increased CEA level predicted the increased risk of mediastinal lymph node metastasis. Combined use of these factors improved the diagnostic capacity for predicting N2 disease preoperatively. Invasive mediastinal staging should be considered for patients with these risk factors, even those with a negative mediastinum on PET/CT. ? 2019 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.
机译：本研究的目的是探讨术前18 f-氟氧基 - 葡萄糖PET / CT节点阴性肺腺癌患者中潜水介质淋巴结转移（MLNM）的预测因素。我们审查了360名连续肺腺癌患者的临床资料和PET / CT参数，该患者计划进行解剖学肺切除和全身纵隔节点解剖。节点转移是病理定义的，并根据2011年IASLC / ATS / ERS分类进行分类所有切除的肿瘤。进行单变量和多变量分析以评估临床病理变量和MLNM之间的关联。在所有360例患者中，54例（15.0％）有病理N2疾病。血清CEA水平，结节型，肝脏Nodal Suvmax，肿瘤Suvmax，尺寸，位置和组织学亚型与MLNM显着与单变量分析有关。在多变量分析中，CEA？≥？5.0 ng / ml（p？<0.001），固体结节（p = 0.012），肿瘤suvmax？≥？3.7（p？<β027），肝脏节点suvmax？≥？2.0（ p？<？0.001）和中心位于肿瘤（p = 0.035）是MLNM的独立危险因素。用于肿瘤Suvmax和Hilar Nodal Suvmax的ROC曲线（AUC）下的面积分别为0.764和0.730，并将五种因子的组合使用产生了0.885的0.885。增加原发性肿瘤和肝淋巴结Suvmax，固体结节，中心位肿瘤和增加的CEA水平预测纵隔淋巴结转移的风险增加。结合使用这些因素提高了术前预测N2病的诊断能力。对于这些危险因素的患者，应考虑侵袭性纵隔分期，即使是PET / CT上有阴性亚氏菌素的患者。 ？ 2019年的作者。中国肺部肿瘤集团和约翰瓦里和儿子澳大利亚发表的胸癌

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