CAJ | 학술논문

目的比较电视纵隔镜和多排螺旋CT在诊断非小细胞肺癌纵隔淋巴结转移上的临床价值,比较两者之间的差异,探讨两者在诊断非小细胞肺癌纵隔淋巴结转移上的优势.方法 2009年10月至2011年8月,我院手术收治的肺癌患者48例,均行术前电视纵隔镜检查和多排螺旋CT检查；以手术清扫淋巴结的病理诊断为金标准,分析电视纵隔镜和多排螺旋CT诊断纵隔淋巴结转移的敏感性、特异性等.结果 48例患者中,术后病理显示,11例出现纵隔淋巴结转移.多排螺旋CT可以准确判断纵隔淋巴结转移8例,准确率为89.58%;电视纵隔镜可以准确判断纵隔淋巴结转移10例,准确率为97.92％；电视纵隔镜诊断准确率优于多排螺旋CT( P＜0.05).多排螺旋CT诊断性灵敏度为72.73％,特异度为94.59％,假阴性率为27.27％,假阳性率为5.41％,总的阳性和阴性预测值分别是80.00％和92.1 1％,约登指数为67.31％;电视纵隔镜诊断性灵敏度为90.91％.特异度为100.00％,假阴性率为9.09％,假阳性率为0.00％,总的阳性和阴性预测值分别是100.00％和97.37％,约登指数为90.90％.结论电视纵隔镜检查和多排螺旋CT均可以诊断肺癌纵隔淋巴结转移,但电视纵隔镜检查有更高的敏感性和准确性.
목적 비교전시종격경화다배라선CT재진단비소세포폐암종격림파결전이상적림상개치,비교량자지간적차이,탐토량자재진단비소세포폐암종격림파결전이상적우세.방법 2009년10월지2011년8월,아원수술수치적폐암환자48례,균행술전전시종격경검사화다배라선CT검사；이수술청소림파결적병리진단위금표준,분석전시종격경화다배라선CT진단종격림파결전이적민감성、특이성등.결과 48례환자중,술후병리현시,11례출현종격림파결전이.다배라선CT가이준학판단종격림파결전이8례,준학솔위89.58%;전시종격경가이준학판단종격림파결전이10례,준학솔위97.92％；전시종격경진단준학솔우우다배라선CT( P＜0.05).다배라선CT진단성령민도위72.73％,특이도위94.59％,가음성솔위27.27％,가양성솔위5.41％,총적양성화음성예측치분별시80.00％화92.1 1％,약등지수위67.31％;전시종격경진단성령민도위90.91％.특이도위100.00％,가음성솔위9.09％,가양성솔위0.00％,총적양성화음성예측치분별시100.00％화97.37％,약등지수위90.90％.결론 전시종격경검사화다배라선CT균가이진단폐암종격림파결전이,단전시종격경검사유경고적민감성화준학성.
Objective To cpmpare the clinical value of video-mediastinoscopy and multi-slice spiral CT ( MSCT ) in determining mediastinal lymphatic metastasis of non-small eel] lung cancer ( NSCLC ).Methods From October 2009 to August 201 I,48 patients with NSCLC undergoing surgical treatment were preoperatively investigated by video-mediastinoecopy and MSCT in our hospital.Pathological diagnosis of mediastinal lymph nodes dissection accepted as the gold standard to examine the sensitivity and specificity of video-mediastinoscopy and MSCT.Results A total of 11　of the 48 patients with NSCLC were pathologically confirmed as mediastinal lymphatic metastasis.8 patients with mediastinal lymphatic metastasis were accurately detected by CT,with an accuracy of 89.58％,while 10patients were accurately confirmed by video-mediastinoscopy,with an accuracy of 97.92％.The accuracy of video-mediastinoscopy was superior to that of MSCT ( P＜ 0.05 ).The sensitivity,specificity,false negative rate,false positive rate,positive predictive value,negative predictive value,and Youden’s index for detecting mediastinal lymphatic metastasis were 72.73％,94.59％,27.27％,5.41％,80.00％,92.11％,and 67.31by CT,respectively,versus 90.91％,100.00％,9.09％,0.00％,100.00％,97.37％,and 90.90％ by videomediastinoscopy,respectively.Conclusions Both video-mediastinoscopy and MSCT can detect mediastinal lymphatic metastasis of lung cancer; and video-mediastinoscopy has a better sensitivity and and better accuracy.of the 48 patients with NSCLC were pathologically confirmed as mediastinal lymphatic metastasis.8 patients with mediastinal lymphatic metastasis were accurately detected by CT,with an accuracy of 89.58％,while 10patients were accurately confirmed by video-mediastinoscopy,with an accuracy of 97.92％.The accuracy of video-mediastinoscopy was superior to that of MSCT ( P＜ 0.05 ).The sensitivity,specificity,false negative rate,false positive rate,positive predictive value,negative predictive value,and Youden’s index for detecting mediastinal lymphatic metastasis were 72.73％,94.59％,27.27％,5.41％,80.00％,92.11％,and 67.31by CT,respectively,versus 90.91％,100.00％,9.09％,0.00％,100.00％,97.37％,and 90.90％ by videomediastinoscopy,respectively.Conclusions Both video-mediastinoscopy and MSCT can detect mediastinal lymphatic metastasis of lung cancer; and video-mediastinoscopy has a better sensitivity and and better accuracy.