Korean J Thorac Cardiovasc Surg.  1998 Mar;31(3):271-278.

Evaluation of Lymph Node Staging of Chest CT in NSCLCa

• Sung SW
• Kim YT
• Kim DS
• Kim JH
• Lim JK

Abstract

In order to access the value of computed tomography in mediastinal LN staging of NSCLCa, 581 LN stations of 77 patients were selected from 552 patients who were diagnosed as Lung Ca and operated in Seoul National University Hospital from 1992 to 1995. The selection criteria were as follows ; the patients 1) whose preoperative chest CTs were available; 2) underwent curative resection (lobectomy or more) with complete lymph node dissection; 3) whose final pathologic diagnosis were proven to be non-small cell lung cancer. We adopted Receiver Operating Characteristic curve method to determine a proper size criterion for diagnosing malignant mediastinal adenopathy. From curve analysis, we decided the size criterion of lymph node to 1 cm in their short axis. Using this size criterion, it's sensitivity was 43.9%, specificity was 87.4%, and accuracy was 83.1%. Eventhough we couldn't determine the precise size criterion for the adenoca, it seemed that shorter than 1 cm size criterion should be applied in that particular cell type. Lymph node stations associated with the tuberculosis or bronchiectasis tend to be overestimated in nodal staging and have relatively high false positive rate. The low sensitivity of CT scan suggest that radical and complete dissection or precise mediastinal lymph node evaluation through the surgical approach is mandatory.

Keyword

Lymph node; Carcinoma; non-small cell; lung; Tomography; x-ray computed

MeSH Terms

Axis, Cervical Vertebra
Bronchiectasis
Carcinoma, Non-Small-Cell Lung
Diagnosis
Humans
Lung
Lymph Node Excision
Lymph Nodes*
Patient Selection
ROC Curve
Sensitivity and Specificity
Seoul
Thorax*
Tomography, X-Ray Computed*
Tuberculosis