Comparision Of Preoperative CT Clinical Stage And Postoperative Pathological Stage Of Non-small Cell Lung Cancer

Objectives:To investigate the accuracy of chest computed tomography (CT) in preoperative clinical staging of non-small cell lung cancer, analysis the reason of difference between CT clinical staging and surgical pathologic staging, and provide the reference to stage correctly choose therapeutic methods properly. Methods:176 operated patients with non-small cell lung cancer were included in the trial. Chest CT were given routinely. According to the clinical examination and CT image, clinical staging (CTNM) were classified and treatment were chosen respectively. All patients were undergone thoracotomy. Postoperative pathologic staging (PTNM) were classified in accordance with the surgical tumor circumstance and pathologic results. Two stage, clinical stage and pathologic stage, are compared, and the accuracy, specificity and sensitivity of each clinical stage are calculated. Some CT images (chest wall invasion, mediastinal invasion and lymph node metastasis) are also compared with surgical and pathologic results and the sensitivity, specificity andaccuracy are calculated respectively.Results:The accuracy of clinical stage of â… ~â…¡, â…¢a and â…¢b are 81.3%, 72.2%and 84.1% respectively.The sensitivity of stage â… ~â…¡ is 82.1%, the specificity, 80.8%; Thesensitivity of stage â…¢a is 78.0%, the specificity, 65.9%; Thesensitivity of stage â…¢b is 13.8%, the specificity, 98.0%.The accuracy of chest wall invasion, mediastinal invasion and lymphnode metastasis of CT images are 74.0%, 62.0% and 61.2%respectively. The sensitivity of chest wall invasion is 71.3%, thespecificity, 79.2%; The sensitivity of mediastinal invasion is 72.1%,the specificity, 85.7%; The sensitivity of lymph node metastasis is65.9%, the specificity, 60.4%.Conclusion:1. The accuracy of chest CT is better in staging and diagnosing of non-small cell lung cancer. Chest CT examination becomes a standard measurement of staging in non-small cell lung cancer and provides the evidence of establishment treatment strategy.2. The sensitivity and specificity of chest CT is higher in estimatingand classifying stage â… ~â…¡ and primary tumor (T).3. There are a certain sensitivity and specificity in chest CT examination of stage â…¢a.4. In stage â…¢b lung cancer staging, CT examination have a poor sensitivity and a good specificity.5. The judging of Hilus pulmonis and mediastinal lymph nodes metastasis is based on the measurement of lymph nodes short diameter. There would be some difference between the CT image results and pathologic results. The sensitivity and specificity are all poor.