磨人的ldquo葡萄rdquo,

—题目—

InvasiveStagingProceduresDoNotPreventNodalMetastasesfromBeingMissedInStageILungCancer.

侵入性分期手段难以降低I期肺癌中隐匿性淋巴结转移

—摘要—

BACKGROUND:

Upto20%ofclinicalstageIlungcancerpatientsharborlymphnodemetastasesthatgoundetected(missed)duringtheclinicalstagingevaluation.Weinvestigatedtowhatdegreetheadditionofinvasivenodalstagingprocedurestoimaging,ascurrentlypracticed,preventsradiographically-occultnodalmetastasesfrombeingmissedduringtheclinicalstagingevaluation.

背景

在临床分期评估中，I期肺癌患者高达20%的患者出现淋巴结转移却未被发现。我们回顾了目前临床实践中的临床分期评估，在影像学评估的基础上增加侵入性纵隔淋巴结分期方法后，能在多大程度上降低影像学隐匿性淋巴结转移。

METHODS:

Treatment-na?vepatients,imagedbyPETandCTscanning,thatunderwentlobectomyforclinicalstageIlungcancerfrom-17intheSocietyofThoracicSurgeonsGeneralThoracicSurgeryDatabasewerestudied.Ratesofmissednodalmetastases(MNM)(i.e.nodalmetastasesinlobectomyspecimens-undetectedduringclinicalstagingevaluation)weredetermined.Riskfactorswereassessedwithmultivariablemodeling.

方法：

本研究纳入了STS普胸外科数据库中于-年，未经辅助治疗，行PET、CT检查后接受了肺叶切除术的临床I期肺癌。对隐匿性淋巴结转移（肺叶切除术后发现的淋巴结转移——临床分期评估中未发现）的比例进行了统计分析。使用多因素分析进行高危因素的筛选评估。

RESULTS:

Ofthe30,clinicalstageIpatientsidentified,3,(12.7%)underwentpreoperativeEBUSand3,(10.9%)underwentmediastinoscopy.Invasivestagingwasmore