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IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology Pub Date : 2025-02-11 DOI:10.1016/j.crad.2025.106843

K. Gambuś , B. Kużdżał , K. Moszczyński , S. Popovchenko , A. Szlubowski , L. Rudnicka , K. Żanowska , Ł. Trybalski , A. Galas , P. Kocoń

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引用次数: 0

摘要

目的对于正电子发射断层扫描（PET）阴性的肺癌，纵隔有创诊断方法的作用仍不明确。本研究旨在确定联合支气管内超声（EBUS）和内镜超声（EUS）（简称为联合超声（CUS））诊断该类患者 N2 疾病的敏感性和阴性预测值（NPV）。所有患者均接受了正电子发射计算机断层扫描（PET-CT），随后进行了 CUS 成像检查和肺切除术，并进行了系统性淋巴结清扫。结果分析了 596 名患者的数据。N2 病变的发生率为 8%。CUS 检测 N2 疾病的敏感性、特异性和 NPV 分别为 14%、98% 和 93%。灵敏度和 NPV 与年龄、性别、体重指数 (BMI)、肿瘤分级、肺叶位置或组织学类型无明显关系（P > 0.05）。在 43 例 CUS 结果为阴性的患者中，有 37 例发现了极小的 N2 病变；在 596 例患者中，只有 6 例因 CUS 而漏诊了超过极小（N2b）的病变。结论 PET 阴性纵隔淋巴结的 N2 病变发生率较低。结论在 PET 阴性的纵隔淋巴结中，N2 病变的发生率较低。CUS 对 N2 病变的 NPV 为 93%，对 N2 以上微小受累的 NPV 为 98%。CUS 的诊断率不受临床特征的影响，是 PET 阴性患者排除明显 N2 疾病的可靠方法，并有可能减少对更多侵入性手术的需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Diagnostic validity of combined transbronchial and transoesophageal ultrasound in positron emission tomography node–negative lung cancer

Aim

The role of invasive mediastinal diagnostic methods in lung cancer with negative positron emission tomography (PET) remains unclear. This study aimed to determine the sensitivity and negative predictive value (NPV) of combined endobronchial ultrasound (EBUS) and endoscopic ultrasound (EUS), referred to as combined ultrasound (CUS), for diagnosing N2 disease in this group of patients.

MATERIALS AND METHODS

single-centre study analysing medical records of clinical stage I to IVA lung cancer patients was conducted. All patients underwent positron emission tomography computed tomography (PET-CT), followed by CUS imaging and lung resection with systematic lymph node dissection. Pathological examination of lymph nodes was the reference standard.

RESULTS

Data from 596 patients were analysed. The prevalence of N2 disease was 8%. The sensitivity, specificity, and the NPV of CUS in detecting N2 disease were 14%, 98%, and 93%, respectively. Sensitivity and NPV were not significantly associated with age, sex, body mass index (BMI), tumour grade, lobar location, or histological type (P > 0.05). Minimal N2 disease was found in 37 of 43 patients with negative CUS results; only 6 of 596 patients had more than minimal (N2b) disease missed by CUS. The NPV for minimal N2 involvement was 98%.

CONCLUSION

In PET-negative mediastinal lymph nodes, N2 disease prevalence is low. CUS has an NPV of 93% for N2 disease and 98% for more than minimal N2 involvement. The diagnostic yield of CUS is unaffected by clinical characteristics, making it a reliable method for ruling out significant N2 disease in PET-negative patients and potentially reducing the need for more invasive procedures.

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来源期刊

Clinical radiology 医学-核医学

CiteScore

4.70

自引率

3.80%

发文量

528

审稿时长

76 days

期刊介绍： Clinical Radiology is published by Elsevier on behalf of The Royal College of Radiologists. Clinical Radiology is an International Journal bringing you original research, editorials and review articles on all aspects of diagnostic imaging, including: • Computed tomography • Magnetic resonance imaging • Ultrasonography • Digital radiology • Interventional radiology • Radiography • Nuclear medicine Papers on radiological protection, quality assurance, audit in radiology and matters relating to radiological training and education are also included. In addition, each issue contains correspondence, book reviews and notices of forthcoming events.