Clinical Analysis Of 59 Patients With Enlarged Mediastinal Lympth Node Who Were Undergone Biopsy By VM

Objective:To investigate the clinical characteristics of enlarged mediastinal lympth node,application of CT,PET/CT,fiberbronchoscopy,VM in the diagnosis of enlarged mediastinal lympth node and application of VM in the staging of the lung cancer with enlarged mediastinal lympth node.Methods:Clinical data of patients with enlarged mediastinal lympth node from August 2005 to December 2008 who was undergone biopsy by VM,were collected from Shandong Province Hospital affiliated Shandong University. According to their diagnosis before VM,the patients were divided into two groups.One is the reason was unkonwn before VM and the other is the lung cancer group.The two groups were analyzed independly by the diagnosis before and after VM.In the first group,gender,age,smoking index,clinical manifestations were included to discuss common disease and their clinical characteristic.The diagnosis and stage accuracy of the second group by CT,PET/CT,fiberbronchoscopy and VM was further analyzed.Results:In the first group,pathological diagnosis were identifyied that 19 cases were sarcoidosis,9 cases were mediastinum tubeculosis,2 cases were squamous cell cancinoma,4 cases were adenocarcinoma,1 case was small-cell cancer,3 case was neuroendocrine carcinoma,3 cases were lymphomaand and 2 was unidentified reactive hyperplasia.There was significant difference between malignant group and benign group in age,gender,smoking index and clinical manifestations.Sensitivity and specificity in the diagnosis of the first group for CT were 84.6%and 57.1%.In the lung cancer group,all the 16 cases were clarified by VM,with a diagnostic accuracy of100%.VM showed positive results in 14 cases,and negative in 2 cases in which the surgical exploration found no evidence of metastasis to mediastinal lymph nodes.4 cases receiving fiberbronchos- copy were not given a clear diagnosis and 2 cases receiving PET were confirmed positive results.Conclusions:In the patients with unknown enlarged mediastinal lympth node,The incidence of malignacy increases with age and smoking index.There is obvious correlation between gender,clinical manifestations in the incidence of malignant enlarged mediastinal lympth node.Specificity for CT and Sensitivity for fiberbronchoscopy in the diagnosis of enlarged mediastinal lympth node is poor.VM is valuable in the diagnosis of unknown enlarged mediastinal lympth node and provides the pathological diagnosis for suspicious N2 or N3 lymphdenopathy of lung cancer.VM is a safe,accurate porceduer and important technique which can acquire pathological diagnos.