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, provide the reference to stage correctly choose therapeutic methods properly. Methods: 90 operated patients with non-small cell lung cancer were included in the trial. Chest CT was given routinely. According to the clinical examination and CT image, clinical staging (CTNM) were classified and treatment were chosen respectively. 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. Stages are calculated. Lymph node metastasis is also compared with surgical and pathologic results and the sensitivity, specificity and accuracy are calculated respectively. Results: The accuracy of clinical stage of I - II, IIIA and IIIB are 76.7%, 74.4% and 97.8% respectively. The sensitivity of stage I—II is 78.4%, the specificity, 75.4%,sensitivity of stage IIIA is 72%, the specificity, 77.5%; sensitivity of stage IIIB is 66.7%, the specificity, 98.6%. Specificity, 79.2%; the sensitivity of mediastinal invasion is 72.1%, the specificity, 85.7%; the sensitivity of lymph node metastasis is 64.2%, the specificity, 55.9%. 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 estimating and classifying stage I -II and primary tumor (T). 3) There are bettet specificity and specificity in chest CT examination of stage IIIa. 4. In stage IIIb, 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, It should be combined with other investiga- tions, such as PET or mediastinoscopy, to assess a more accurate mediastinal lymph node staging.