非小细胞肺癌纵隔淋巴结分期诊断研究进展

发布时间：2018-04-11 23:09

本文选题：非小细胞肺癌 + 纵隔分期　；参考：《中华肿瘤防治杂志》2017年05期

【摘要】：目的肺癌是全球死亡率最高的恶性肿瘤之一,其中80%是非小细胞肺癌(non-small cell lung cancer,NSCLC)。本研究回顾总结国内外NSCLC纵隔淋巴结分期诊断的研究进展,为临床采取合适的检查方法及治疗方案提供一定指导。方法应用PubMed、中国知网、万方数据库、维普中文期刊服务平台等检索系统,以"NSCLC、术前、纵隔淋巴结分期、电子发射计算机体层显像-X线计算机体层(integrated positron emission tomography-computed tomography,PET-CT)、计算机断层成像(computed tomography,CT)、磁共振成像(magnetic resonance imaging,MRI)、纵隔镜、针吸活检术"为关键词,检索2000-07-27-2016-03-05相关文献,纳入标准:(1)NSCLC纵隔淋巴结的有创性外科检查方法;(2)NSCLC纵膈淋巴结的无创性影像学检查方法。结果根据纳入标准纳入分析40篇相关文献。总结出无创性影像学分期、有创性外科分期各检查的优缺点、灵敏度、特异度、准确度、假阳性率、假阴性率及临床应用情况。NSCLC纵隔淋巴结检查方法中,CT对纵隔淋巴结分期的灵敏度(61.1%)及特异性(71.1%)均较低;脱氧葡萄糖(fluorodeoxyglucose,FDG)PET-CT灵敏度和特异度分别是64%和83.3%,但其价格昂贵;磁共振扩散加权成像诊断NSCLC纵隔淋巴结转移的效能优于FDG PET-CT;纵隔镜灵敏度和特异度分别是78%和100%,存在一定的并发症(2%)和死亡率(0.08%);支气管内镜超声引导针吸活检操作方便,其灵敏度和特异度分别是92%和100%,不能取检主动脉旁及下纵隔淋巴结。结论 CT已作为评估NSCLC纵隔淋巴结分期的常规检查;FDG PET-CT是最准确的无创性检查方法;纵隔镜是目前诊断纵隔淋巴结分期的金标准,未来的趋势是各技术整合、优势互补以达到更准确的NSCLC纵隔分期。
[Abstract]:Objective lung cancer is one of malignant tumors with the highest mortality worldwide, of which 80% non-small cell lung cancer (non-small cell lung cancer, NSCLC). The research progress of this study reviewed NSCLC mediastinal lymph node staging, clinical examination methods and take appropriate treatment plan to provide some guidance. The application of PubMed, China HowNet, Wanfang database, retrieval system Chinese VIP periodical service platform, with NSCLC, preoperative mediastinal lymph node staging, electron emission computed tomography X-ray computed tomography (integrated positron emission tomography-computed tomography, PET-CT), computer tomography (computed tomography, CT, magnetic resonance imaging (magnetic) resonance imaging, MRI), mediastinoscopy, needle aspiration "as key words, search 2000-07-27-2016-03-05 related literature into standard: (1) NSCLC invasive mediastinal lymph node Surgical examination method; (2) non-invasive imaging methods NSCLC mediastinal lymph nodes. Results according to the inclusion criteria, 40 articles were included in the analysis. Summarize the noninvasive imaging staging, have advantages and disadvantages, invasive surgical staging of the examination of the sensitivity, specificity, accuracy, false positive rate. The false negative rate and clinical application of.NSCLC mediastinal lymph node examination method, the sensitivity of CT in staging mediastinal lymph node (61.1%) and specificity (71.1%) were low; deoxyglucose (fluorodeoxyglucose, FDG) PET-CT sensitivity and specificity were 64% and 83.3%, but the price is expensive; diffusion weighted magnetic resonance imaging NSCLC diagnosis of mediastinal lymph node metastasis is better than FDG PET-CT; mediastinoscope sensitivity and specificity were 78% and 100%, there are some complications (2%) and mortality (0.08%); bronchial endoscopic ultrasound guided needle biopsy operation is convenient, its sensitivity And the specificity were 92% and 100%, not biopsy of mediastinal lymph node and lower aorta. Conclusion CT has been assessing mediastinal lymph node staging NSCLC routine examination; FDG PET-CT is a noninvasive method for the most accurate mediastinoscopy; mediastinal lymph node staging is currently the gold standard, the future trend is the technology the integration of complementary advantages, to achieve a more accurate NSCLC staging of the mediastinum.

【作者单位】：济南大学·山东省医学科学院医学与生命科学学院;山东省医学科学院;山东大学附属山东省肿瘤医院放疗科山东省医学科学院;
【基金】：国家自然科学基金(NSFC81372413) 山东省自然科学杰出青年基金(2014JQ223)
【分类号】：R734.2

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