비소세포폐암에서 종격동경검사의 안전성과 유용성

Abstract

Background: Mediastinal lymph node metastasis is an important factor for staging and prognosis of non-small cell lung cancer (NSCLC), so accurate diagnosis is essential for treatment. Mediastinoscopy provides histopathological diagnosis of mediastinal lymphnode metastasis in NSCLC. The efficacy of mediastinoscopy was investigated.

Material and Method: From Jun, 1999 to Aug, 2005, mediastinoscopic lymph node biopsy was performed to 348 patients with NSCLC. Patients characteristics, radiologic findings, mediastinoscopic results and pathologic stages were evaluated for investigation of safety and efficacy of mediastinoscopy in NSCLC.

Result: There was 263 male and 85 female patients and the mean age was 62.1⁑8.5 years. By radiologic study for mediastinal lymph node metastasis, 203 patients were negative and 145 patients were positive. Mean procedure time was 55.5⁑16.5 minutes and biopsy was performed at 2.2⁑1.0 lymph node stations. There were only transient complications (1.7%) during the procedure, without other complication and mortality. There was 7.8% of false negative result in mediastinoscopy. Sensitivity (77.5% vs 71.9%, p=0.012), specificity (100% vs 74.4%, p=0.00), and accuracy (92.2% vs 73.6%, p=0.00) of mediastinoscopy were more superior than that of radiologic study for the diagnosis of mediastinal lymph node metastasis in NSCLC.

Conclusion: Mediastinoscopy is a safe and effective modality for diagnosis of mediastinal lymph node metastasis in NSCLC.