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KMID : 0371620010160010039
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Journal of Wonkwang Medical Science
2001 Volume.16 No. 1 p.39 ~ p.46
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Comparison of Intrathoracic Lymph Node Diameter Criteria as Lung Cancer Involvement
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Kuk Hiang
Yang Sei-Hoon
Jeong Eun-Taik
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Abstract
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Background : The original purpose for the CT scan of the chest was that it would be able to predict involvement of the intrathoracic lymph node in the lung cancer noninvasively. When trying to evaluate nodal involvement by CT scan, largest diameter of nodes must be measured. Intrathoracic nodes larger than 15㎜ in diameter have cancer involvement in 94 - 97%, whereas nodes ranging from 10 to 15㎜ have cancer involvement in 50%, and those less than 10㎜ are usually uninvolved. Diameter of normal intrathoracic lymph node is influenced by location, as larger nodes in subcarinal area and smaller nodes in paraesophageal area. So, we tried to analyse the accuracies between nodal involvement criteria according to largest diameter by CT scan (positive if larger than 10㎜, 15㎜ and our modified criterion).
Materials and Methods : We regarded them as involvement if ATS node No.4, 5, 7, 10R were larger than 15㎜ and others were larger than 10㎜ in diameter. The pathologic involvement and size of the nodes removed from surgery of 57 patients with proven lung cancer were analysed.
Results : The sensitivity, specificity, positive and negative predictive value and accuracy were 97%, 54%, 68%, 94%, 75% in critierion as node involvement if larger than 10㎜. There were 79%, 75%, 77%, 77%, 77% in criterion as node involvement if larger than 15㎜, and those were 86%, 75%, 78%, 84%, 81% in our modified critierion.
Conclusion: Our modified criterion for intrathoracic lymph node involvement (as positive if largest diameter of ATS map 4,5,7,10R were larger than 15mm, and those of others were larger than 10㎜) was more accurate than other previous criteria (as positive if largest diameter of lymph node were larger than 10㎜ or 15㎜).
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KEYWORD
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Lung cancer, TNN stage, CT scan
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