TY - JOUR
T1 - Evaluation of lymph node metastasis in lung cancer
T2 - Who is the chief justice?
AU - Xia, Yang
AU - Zhang, Bin
AU - Zhang, Hao
AU - Li, Wen
AU - Wang, Ko Pen
AU - Shen, Huahao
N1 - Publisher Copyright:
© Journal of Thoracic Disease. All rights reserved.
PY - 2015
Y1 - 2015
N2 - Accurate determination of the diagnosis and the stage of lung cancer play a critical role to ensure that patients are provided the optimal treatment. However, the process is usually beyond complex. Early studies have suggested lymph nodes (LNs) >1.0 cm in size on computed tomography (CT) are considered as metastatic nodes, while the sensitivity of this criterion is not satisfied. Subsequently, positron emission tomography-computed tomography (PET-CT) was shown to be superior to CT alone on assessment of nodal involvement and was widely used to estimate suitability for resection with curative intent, but the dependability also remains controversial. Furthermore, transbronchial needle aspiration (TBNA) with and without endobronchial ultrasound (EBUS), as a well-accepted minimally invasive approach for LN biopsy, has been documented as an efficient tool in evaluation of CT and PET-CT negative LNs. Additionally, radiographic features including ground-glass/solid nodules ratio, referring as imaging biomarker, were indicated to be correlated with metastasis. Hence, we highlight the importance of comprehensive estimation of mediastinal and hilar LNs, and we suggested the judgment of LNs by radiographic tools alone might not be reliable and TBNA is indispensable in certain circumstances.
AB - Accurate determination of the diagnosis and the stage of lung cancer play a critical role to ensure that patients are provided the optimal treatment. However, the process is usually beyond complex. Early studies have suggested lymph nodes (LNs) >1.0 cm in size on computed tomography (CT) are considered as metastatic nodes, while the sensitivity of this criterion is not satisfied. Subsequently, positron emission tomography-computed tomography (PET-CT) was shown to be superior to CT alone on assessment of nodal involvement and was widely used to estimate suitability for resection with curative intent, but the dependability also remains controversial. Furthermore, transbronchial needle aspiration (TBNA) with and without endobronchial ultrasound (EBUS), as a well-accepted minimally invasive approach for LN biopsy, has been documented as an efficient tool in evaluation of CT and PET-CT negative LNs. Additionally, radiographic features including ground-glass/solid nodules ratio, referring as imaging biomarker, were indicated to be correlated with metastasis. Hence, we highlight the importance of comprehensive estimation of mediastinal and hilar LNs, and we suggested the judgment of LNs by radiographic tools alone might not be reliable and TBNA is indispensable in certain circumstances.
KW - Computed tomography (CT)
KW - Lung cancer
KW - Lymph node (LN) metastasis
KW - Positron emission tomography-computed tomography (PET-CT)
KW - Transbronchial needle aspiration (TBNA)
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U2 - 10.3978/j.issn.2072-1439.2015.11.63
DO - 10.3978/j.issn.2072-1439.2015.11.63
M3 - Review article
AN - SCOPUS:84958676261
VL - 7
SP - S231-S237
JO - Journal of Thoracic Disease
JF - Journal of Thoracic Disease
SN - 2072-1439
ER -