Comparison of size criteria in mediastinal lymph node involvement of adenocarcinoma of lungs

Gu, Ki Seon; Kuk, Hiang; Koh, Hyeck Jae; Yang, Sei Hun; Jeong, Eun Taik

Abstract

BACKGROUND: Decision in mediastinal lymph node involvement of lung cancer by CT scan is very important and valuable for the treatment planning and prognosis prediction. In general, long diameter of mediastinal lymph node more than 15mm is used as criterion of lung cancer involvement. Adenocarcinoma has a tendency of early distant metastasis and micrometastasis, so adenocarcinoma may involve lymph node earlier and cannot be detected before lymph nodes are enlarged enough. The authors tried to determine the difference between two size criteria (15mm, 10mm) in adenocarcinoma for the detection of cancer involvement.
METHODS
Numbers of sample are 60 cases (male 46, female 14, median age: 61.5 years). According to pathology, squamous cancer 41, large cell cancer 2, adenocarcinoma 17. According to TNM stage, I 23, II 24, IIIA 13.
RESULTS
Mean long diameter of lymph node involvement is 16.0(+/-8.0) mm in non-adenocarcinoma group, and that of adenocarcinoma group is 12.0(+/-3.2) mm(p<0.05). If long diameter of lymph node larger than 15mm as involvement criterion is applied, sensitivity, specificity, positive predictive index, negative predictive index, accuracy of nonadenocarcinoma group are 54%, 100%, 100%, 83%, 86%, and those of adenocarcinoma group are 43%, 90%, 75%, 69%, 71%. If long diameter of lymph node larger than 10mm as involvement criterion is applied, sensitivity, specificity, positive predictive index, negative predictive index, accuracy of nonadenocarcinoma group are 65%, 77%, 61%, 92%, 79%, and those of adenocarcinoma group are 100%, 80%, 78%, 100%, 88%.
CONCLUSION
Long diameter of lymph node larger than 10mm is more valuable criterion as lymph node involvement in adenocarcinoma of lungs.