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New Endoscopic Ultrasound (EUS) Applications in Lung Cancer: Evaluation of Patients with Negative Mediastinal CT and Re-Staging after Neoadjuvant Treatment
被引:2
|作者:
Fernandez-Esparrach, Gloria
[1
]
Sendino, Oriol
[1
]
Gines, Angels
[1
]
机构:
[1] Univ Barcelona, Secc Endoscopia, Serv Gastroenterol, ICMDiM,Hosp Clin,IDIBAPS,CIBERehd, Barcelona, Spain
来源:
ARCHIVOS DE BRONCONEUMOLOGIA
|
2011年
/
47卷
/
08期
关键词:
Lung cancer;
Staging;
Restaging;
Adjuvant therapy;
EUS;
EUS-FNA;
FINE-NEEDLE-ASPIRATION;
COMPARING PERIOPERATIVE CHEMOTHERAPY;
ENDOBRONCHIAL ULTRASOUND;
INDUCTION THERAPY;
REPEAT MEDIASTINOSCOPY;
COMPUTED-TOMOGRAPHY;
LYMPH-NODES;
FDG-PET;
STAGE;
REMEDIASTINOSCOPY;
D O I:
10.1016/j.arbres.2011.03.002
中图分类号:
R56 [呼吸系及胸部疾病];
学科分类号:
摘要:
The main purpose of staging in non-small cell lung cancer (NSCLC) is to assess mediastinal lymph node involvement, with thoracic CT being the main non-invasive test for this. However, given that up to 15% of patients who show no mediastinal lymph node involvement in the CT have lymph node metastasis during surgery, other examinations are required. Endoscopic ultrasonography guided fine-needle aspiration (EUS-FNA) has shown to be able to detect advanced disease (metastatic mediastinal lymph nodes, adrenal metastasis, mediastinal invasion by the tumour) in approximately 25% of patients with a CT that suggested a non-advanced disease. Another situation in which CT has a very limited value is in the evaluation of the response to induction therapy, with its most limiting factor being its intrinsic inability to distinguish between a tumour and necrosis. In this context, EUS-FNA has shown to have a good performance, with a sensitivity, negative predictive value and precision of 75%, 67% and 83%, respectively. In conclusion, EUS-FNA may be considered a good alternative in the pre-operative staging of patients with NSCLC, with and without diseased mediastinal lymph nodes in CT, and could play an important role in the mediastinal re-staging of these patients by identifying a patient sub-group who might benefit from additional surgical treatment. (C) 2011 SEPAR. Published by Elsevier Espana, S.L. All rights reserved.
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页码:410 / 414
页数:5
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