Evaluation of computed tomography in preoperative staging of primary lung cancer.

概要

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A prospective study was performed in order to evaluate the clinical value of preoperative CT interpretation in 97 primary lung cancer cases. The clinical diagnosis mainly by CT interpretation, surgical diagnosis and histopathological diagnosis were compared. The accuracy of clinical T evaluation was 84% that of histopathological diagnosis. Clinical evaluation of T3 had low sensitivity (69%), but fairly good specificity (95%). The accuracy of clinical N was 62%. Clinical evaluation of N2 was 42% in sensitivity and 81% in specificity.<BR>CT was less sensitive in detecting lymph node metastasis, since small lymph nodes less than 10mm often showed histopathological metastasis, particularly in adenocarcinoma, whereas relatively large lymph nodes, showed no metastasis particularly in squamous cell carcinoma. Mediastinal lymph node metastasis without hilar metastasis was noted in 2 cases with adenocarcinoma.<BR>Preoperative TN staging with CT had low sensitivity, particularly in curatively resected cases. However, CT can play an important role in the determination of resectability.<BR>The most important role of CT in preoperative staging is for evaluation of resectability.
特定非営利活動法人日本肺癌学会の論文