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首页> 外文期刊>Lung cancer: Journal of the International Association for the Study of Lung Cancer >Lymph node staging by means of positron emission tomography is less accurate in non-small cell lung cancer patients with enlarged lymph nodes: analysis of 1,145 lymph nodes.
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Lymph node staging by means of positron emission tomography is less accurate in non-small cell lung cancer patients with enlarged lymph nodes: analysis of 1,145 lymph nodes.

机译：通过正电子发射断层摄影术进行的淋巴结分期在淋巴结扩大的非小细胞肺癌患者中不太准确：分析了1,145个淋巴结。

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BACKGROUND: Despite documented superiority of integrated positron emission tomography-computerized tomography (PET-CT) over computerized tomography (CT) in lymph node staging in non-small cell lung cancer, little is known about the sensitivity, specificity and accuracy of integrated PET-CT among enlarged lymph nodes. We sought to assess if PET-CT is uniformly accurate among enlarged and non-enlarged lymph nodes. METHODS: A retrospective review of 206 consecutive patients with histologically proven non-small cell lung cancer who underwent resection and/or mediastinoscopy in our centre over 30 months period was carried out. All these patients had pre-operative staging with integrated PET-CT as an adjunct to chest CT prior to resection and/or mediastinoscopy. Diabetic patients (BM>or=8.0 mmol/l) and those who received neo-adjuvant chemotherapy were excluded. The pathological results of all these cases were reviewed and correlated with those on CT and integrated PET-CT. RESULTS: The sensitivity, specificity, accuracy, positive and negative predictive values were higher in integrated PET-CT than CT alone in all lymph nodes, whether N1 or N2. When lymph nodes were stratified by size, the sensitivity of PET-CT was significantly higher among enlarged (>1cm) than non-enlarged (1cm) should be with caution as the specificity of PET-CT is lower and its ability to detect truly negative nodes become reduced. NSCLC patients with enlarged nodes by CT criteria who are PET-CT negative may require cervical mediastinoscopy to rule out metastatic spread to these nodes. Prospective studies are warranted.
机译：背景：尽管有文献报道在非小细胞肺癌淋巴结分期中，正电子发射断层扫描-计算机断层扫描（PET-CT）优于计算机断层扫描（CT），但对PET-CT的敏感性，特异性和准确性知之甚少淋巴结肿大的CT。我们试图评估PET-CT在扩大和未扩大淋巴结中是否一致准确。方法：回顾性分析了206例经组织学证实为非小细胞肺癌的患者，这些患者在我们中心进行了30个月的切除和/或纵隔镜检查。所有这些患者在手术前和/或纵隔镜检查前均接受了综合性PET-CT作为胸部CT的辅助分期。排除了糖尿病患者（BM≥8.0mmol / l）和接受新辅助化疗的患者。回顾了所有这些病例的病理结果，并将其与CT和整合式PET-CT的结果相关联。结果：在所有N1或N2淋巴结中，整合PET-CT的敏感性，特异性，准确性，阳性和阴性预测值均高于单独的CT。当淋巴结按大小分层时，PET-CT的敏感性在扩大（> 1cm）中明显高于未扩大（<或= 1cm）淋巴结（74％vs. 40％，P <0.0001），但是特异性显着降低（81％比98％，P <0.0001）和准确性更低（78％比90％，P 0.008）。结论：在非小细胞肺癌的淋巴结分期中，集成式PET-CT仍优于CT。但是，在淋巴结肿大的情况下，PET-CT的特异性降低，准确性降低，但在检测转移至淋巴结的转移方面更加敏感。对NSCLC淋巴结增大（> 1cm）的患者，PET-CT结果的解释应谨慎，因为PET-CT的特异性较低，并且其检测真正阴性结节的能力降低。根据CT标准，PET-CT阴性的淋巴结肿大的NSCLC患者可能需要进行宫颈纵隔镜检查以排除转移扩散到这些淋巴结。前瞻性研究是必要的。

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