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 1145 lymph nodes

医学 纵隔镜检查 淋巴 淋巴结 正电子发射断层摄影术 肺癌 放射科 PET-CT 断层摄影术 核医学 病理
作者
Nael Al-Sarraf,Kathy Gately,Julie Lucey,Lorraine Wilson,Eillish McGovern,Vincent Young
出处
期刊:Lung Cancer [Elsevier BV]
卷期号:60 (1): 62-68 被引量:68
标识
DOI:10.1016/j.lungcan.2007.08.036
摘要

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 ≥ 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 (>1 cm) than non-enlarged (≤1 cm) lymph nodes (74% vs. 40%, P < 0.0001), but with a significantly lower specificity (81% vs. 98%, P < 0.0001) and a lower accuracy (78% vs. 90%, P 0.008). Conclusions Integrated PET-CT remains superior to CT in nodal staging of non-small cell lung cancer. However, in the presence of enlarged lymph nodes, PET-CT becomes less specific, less accurate but more sensitive in detecting metastatic spread to the lymph nodes. Interpretation of PET-CT findings in NSCLC patients with enlarged lymph nodes (>1 cm) 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.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
薛诗棋完成签到,获得积分10
刚刚
刚刚
ABC发布了新的文献求助10
刚刚
1秒前
1秒前
小二郎应助Catalparine_Haw采纳,获得10
1秒前
沉迷学术发布了新的文献求助10
1秒前
1秒前
WentingRao完成签到,获得积分10
2秒前
zhang5657完成签到,获得积分10
2秒前
3秒前
SciGPT应助malo采纳,获得10
4秒前
传奇3应助迷路的初柔采纳,获得10
4秒前
Ahion发布了新的文献求助20
4秒前
4秒前
领导范儿应助丶丶采纳,获得10
4秒前
阿基米德发布了新的文献求助10
4秒前
Jau完成签到,获得积分0
4秒前
帅气的马里奥完成签到 ,获得积分10
5秒前
zzzwwwkkk完成签到,获得积分10
5秒前
aa发布了新的文献求助10
5秒前
dddd发布了新的文献求助10
5秒前
6秒前
赘婿应助璟晔采纳,获得10
6秒前
7秒前
liqin发布了新的文献求助10
7秒前
aaa完成签到,获得积分10
7秒前
7秒前
VAD123发布了新的文献求助20
8秒前
爱尚Coco完成签到,获得积分10
8秒前
小圆子完成签到,获得积分10
8秒前
8秒前
9秒前
DADing完成签到,获得积分20
9秒前
酷波er应助满意芯采纳,获得10
9秒前
兴奋的万声完成签到,获得积分10
9秒前
dddd完成签到,获得积分10
9秒前
王伟应助超级千青采纳,获得10
10秒前
ll应助超级千青采纳,获得10
10秒前
10秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Cognitive Neuroscience: The Biology of the Mind 1000
Technical Brochure TB 814: LPIT applications in HV gas insulated switchgear 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Picture Books with Same-sex Parented Families: Unintentional Censorship 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3969033
求助须知:如何正确求助?哪些是违规求助? 3513900
关于积分的说明 11170818
捐赠科研通 3249256
什么是DOI,文献DOI怎么找? 1794708
邀请新用户注册赠送积分活动 875326
科研通“疑难数据库(出版商)”最低求助积分说明 804759