A series of 225 consecutive lung cancer patients were prospectively randomized into a study group (75 patients) and a control group (150 Palients), and the agreement between CTNM (clinical staging) and PTNM (pathologi...A series of 225 consecutive lung cancer patients were prospectively randomized into a study group (75 patients) and a control group (150 Palients), and the agreement between CTNM (clinical staging) and PTNM (pathological staging) was evaluated. Radical mediastinal lymph node dissection was performed and on an average 11.5 nodes were dissected each case in the study group.Only suspected metastatic lymph nodes, 3.4 on an average,were dissected each cast in the coutrol group. CTNM classification was made according to clinical examination,chest image exainination and bronchoscopy in every patient and PTNM staging was made after thoracotomy.Then the agreement of CTNM and PTNM staging was judged by Kappa value. The results showed that the Kappa value in the two groups was lower than the effective standard value of 0.4, which was poorer in the study groul, (KaPPa=4).097) than that in thecontrol group tKappaed.371). The Principal influencing cause was that N was not well evaluated by CTNM. The priucipal manifestation of the staging iuconsistency was that the stage of PTNM was advanced than that of CTNM. In the study group 43% of patients showeil an increased stage and this occurred in 33% of the control group (P< 0.05).The results of the study show that at present the CTNM staging has not fully satisfied the necds of practice and requires to be further improved. The operative procedure that only suspected involved mediastinal lymph nodes are dissected can not meet the needs of PTNM staging. In order to make PTNM staging accurately and evaluate the results of treatment for lung caucer, radical mediastinal lymph node dissection should be performed in every operable Patient.展开更多
文摘A series of 225 consecutive lung cancer patients were prospectively randomized into a study group (75 patients) and a control group (150 Palients), and the agreement between CTNM (clinical staging) and PTNM (pathological staging) was evaluated. Radical mediastinal lymph node dissection was performed and on an average 11.5 nodes were dissected each case in the study group.Only suspected metastatic lymph nodes, 3.4 on an average,were dissected each cast in the coutrol group. CTNM classification was made according to clinical examination,chest image exainination and bronchoscopy in every patient and PTNM staging was made after thoracotomy.Then the agreement of CTNM and PTNM staging was judged by Kappa value. The results showed that the Kappa value in the two groups was lower than the effective standard value of 0.4, which was poorer in the study groul, (KaPPa=4).097) than that in thecontrol group tKappaed.371). The Principal influencing cause was that N was not well evaluated by CTNM. The priucipal manifestation of the staging iuconsistency was that the stage of PTNM was advanced than that of CTNM. In the study group 43% of patients showeil an increased stage and this occurred in 33% of the control group (P< 0.05).The results of the study show that at present the CTNM staging has not fully satisfied the necds of practice and requires to be further improved. The operative procedure that only suspected involved mediastinal lymph nodes are dissected can not meet the needs of PTNM staging. In order to make PTNM staging accurately and evaluate the results of treatment for lung caucer, radical mediastinal lymph node dissection should be performed in every operable Patient.
