中国肺癌杂志
中國肺癌雜誌
중국폐암잡지
CHINESE JOURNAL OF LUNG CANCER
2014年
2期
171-174
,共4页
毛锋%张良%蔡明辉%丁征平%申屠阳
毛鋒%張良%蔡明輝%丁徵平%申屠暘
모봉%장량%채명휘%정정평%신도양
肺肿瘤%纵隔肿物%纵隔镜检查术%分期%诊断
肺腫瘤%縱隔腫物%縱隔鏡檢查術%分期%診斷
폐종류%종격종물%종격경검사술%분기%진단
Lung neoplasms%Mediastinal mass%Mediastinoscopy%staging%Diagnosis
背景与目的探讨纵隔镜检查术对纵隔肿物诊断和肺癌鉴别诊断/术前分期的临床应用价值。方法共计361例患者纳入研究，其中术前未确诊的纵隔肿物患者162例，疑诊或确诊肺癌并伴有纵隔淋巴结肿大（短径≥1.0 cm）患者199例。所有患者均接受手术，其中经颈纵隔镜检查术（SCM）308例，经胸骨旁纵隔镜检查术（PM）53例。结果①纵隔镜检查术对纵隔肿物诊断的准确性98.11%，敏感性97.62%，特异性100%，阳性预测值100%，阴性预测值91.67%。②纵隔镜检查术对肺癌纵隔淋巴结转移诊断的准确性98.28%，敏感性98.03%，特异性100%，阳性预测值100%，阴性预测值100%。手术相关并发症共计7例，发生率为1.93%。结论纵隔镜检查术创伤轻微、安全可靠、取材足量，对纵隔肿物的诊断价值极高，也是肺癌鉴别诊断和术前分期的重要方法和金标准。
揹景與目的探討縱隔鏡檢查術對縱隔腫物診斷和肺癌鑒彆診斷/術前分期的臨床應用價值。方法共計361例患者納入研究，其中術前未確診的縱隔腫物患者162例，疑診或確診肺癌併伴有縱隔淋巴結腫大（短徑≥1.0 cm）患者199例。所有患者均接受手術，其中經頸縱隔鏡檢查術（SCM）308例，經胸骨徬縱隔鏡檢查術（PM）53例。結果①縱隔鏡檢查術對縱隔腫物診斷的準確性98.11%，敏感性97.62%，特異性100%，暘性預測值100%，陰性預測值91.67%。②縱隔鏡檢查術對肺癌縱隔淋巴結轉移診斷的準確性98.28%，敏感性98.03%，特異性100%，暘性預測值100%，陰性預測值100%。手術相關併髮癥共計7例，髮生率為1.93%。結論縱隔鏡檢查術創傷輕微、安全可靠、取材足量，對縱隔腫物的診斷價值極高，也是肺癌鑒彆診斷和術前分期的重要方法和金標準。
배경여목적탐토종격경검사술대종격종물진단화폐암감별진단/술전분기적림상응용개치。방법공계361례환자납입연구，기중술전미학진적종격종물환자162례，의진혹학진폐암병반유종격림파결종대（단경≥1.0 cm）환자199례。소유환자균접수수술，기중경경종격경검사술（SCM）308례，경흉골방종격경검사술（PM）53례。결과①종격경검사술대종격종물진단적준학성98.11%，민감성97.62%，특이성100%，양성예측치100%，음성예측치91.67%。②종격경검사술대폐암종격림파결전이진단적준학성98.28%，민감성98.03%，특이성100%，양성예측치100%，음성예측치100%。수술상관병발증공계7례，발생솔위1.93%。결론종격경검사술창상경미、안전가고、취재족량，대종격종물적진단개치겁고，야시폐암감별진단화술전분기적중요방법화금표준。
Background and objective To discuss the clinical application of mediastinoscopy in the differential di-agnosis and preoperative staging on lung cancer. Methods A total of 361 cases of patients were included in the study, of which 162 cases were undiagnosed mediastinal tumor patients before operation, and 199 patients were suspected or diagnosed with lung cancer or mediastinal lymph nodes enlargment(short diameter≥1.0 cm). All patients underwent surgery, including 308 cases standard cervical mediastinoscopy (SCM) , 53 cases parasternal mediastinoscopy (PM). Results Taking pathology diag-nosis as the gold standard, the mediastinoscopy diagnostic accuracy, sensitivity, speciifcity, positive predictive value, negative predictive value are 98.11%, 97.62%, 100%, 100%, 91.67%and 98.28%, 98.03%, a 100%, 100%, 100%to mediastinal masses and mediastinal lymph node metastasis of lung cancer. Total seven cases suffered from complications of surgery-related, the complication rate was 1.93 percent (P<0.05). Conclusion hTe trauma of the mediastinoscopy is slight, which is safe, reliable, able to take in suffcient tissue quantities. Mediastinoscopy is highly helpful not only in diagnostic of mediastinal mass, but also in the differential diagnosis of lung cancer, and it’s an important method and the gold standard of preoperative staging on lung cancer.
