2009•China Modern MedicineRequires access
The reasonable manner and scope of hilar and mediastinal lymph node in patients with lung cancer
Yufei Zhu
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Abstract
Objective: To explore the reasonable manner and scope of hilar and mediastinal lymph node in patients with lung cancer. Methods: 45 patients with lung cancer were selected as research subject, who had been treated with surgery from Jan.2006 to Jan.2008 in our hospital.We made a retrospective analysis of its clinical data, analysis preoperative chest CT and MRI of the right hilar and mediastinal lymph node metastasis and postoperative pathology results to determine consistency, while a more systematic sampling of cases of intrathoracic lymph node metastasis frequency in various districts, as well as systematic sampling of hilar and mediastinal lymph node sampling technique purely positive detection rate. Results: The preoperative CT diagnosis and pathological mediastinal lymph node metastasis to the hilar consistency of the results of the inspection, κ was 0.351; MRI diagnosis of consistency tests, κ was 0.449.The consistency of MRI was better than CT,the highest frequency of lymph node metastasis were from the recent 11,10,7,5,4 area around Hilar and pulmonary roots,9,6,3,2,1 area farther away from the root zone pulmonary lymph node metastas was less frequently.Hilar and mediasti nal lymph node systematic sampling of 40 cases, the positive detection rate was 85.0%;pure sample of 10 cases, the positive rate of 60.0%. It was found the positive detection rate between the two groups was significant difference (χ2=13.28, P0.05). Conclusion: The chest CT and MRI should not be the only checks in judging preoperative N staging of lung cancer,further other diagnostic techniques should be introduced to improve the accuracy of staging of hilar and mediastinal lymph nodes. In lung cancer surgery should take the initiative to clear the district of hilar and mediastinal lymph nodes, particularly around the roots of the surrounding hilar or pulmonary lymph nodes.Systematic lymph node sampling for lung cancer compared with radical surgery.