NON-SMALL-CELL LUNG-CANCER - DETECTION OF MEDIASTINAL LYMPH-NODE METASTASES BY ENDOSCOPIC ULTRASOUND AND CT

In this prospective study endoscopic ultra-sound (EUS) and computed to mography (CT) were evaluated to compare diagnostic accuracy of the two methods. They were performed for nodal staging in selected patients a dmitted to out institution for non-small-cell lung cancer (NSCLC). Fro m February 1992 to July 1993, 45 patients were recruited for the study when N3 and N2 nodal involvement were excluded on standard chest X-ra y. All the patients completed EUS and CT exams for staging before trea tment. The results of sensitivity, specificity and accuracy were obtai ned in 30 patients who underwent surgical treatment with macroscopical ly radical resection of T and N, which allowed a complete surgical and histological comparision of CT and EUS findings. On a per-patient bas is CT results were: sensitivity 63.6%, specificity 78.9% and accuracy of 73.3%; on a nodal station basis sensitivity, specificity and accura cy were 70.0%, 85.1% and 81,6%, respectively. The EUS evaluation showe d, on a per-patient basis, values of sensitivity 45.5%, specificity 57 .9% and overall diagnostic accuracy of 53.3%. On a nodal station basis the results were 50.0%, 86.6% and 78.2%, respectively. The results ob tained in the 30 patients when both techniques were taken in associati on regarding sensitivity (90.9%), specificity (73.7%) and accuracy (80 .0%) on a per-patient basis suggest that the association of EUS and CT offers the best approach for preoperative staging of NSCLC.