• 作者：Gloria Ferná ; ndez-Esparrach ; Oriol Sendino ; Angels Ginè ; s ; ^{magines@clinic.ub.es}
• 关键词：Cá ; ncer de pulm&oacute ; n ; Estadificaci&oacute ; n ; Reestadificaci&oacute ; n ; Tratamiento neoadyuvante ; USE ; USE-PAAF
• 刊名：Archivos de Bronconeumolog铆a
• 出版年：2011
• 期刊代码：pca65_03002896
• 类别：med
• 出版时间：August 2011
• 卷：47
• 期：8
• 页码：410-414
• 文件大小：210 K

The main purpose of staging in non-small cell lung cancer (NSCLC) is to assess mediastinal lymph node involvement, with thoracic CT being the main non-invasive test for this. However, given that up to 15%of patients who show no mediastinal lymph node involvement in the CT have lymph node metastasis during surgery, other examinations are required. Endoscopic ultrasonography guided fine-needle aspiration (EUS-FNA) has shown to be able to detect advanced disease (metastatic mediastinal lymph nodes, adrenal metastasis, mediastinal invasion by the tumour) in approximately 25%of patients with a CT that suggested a non-advanced disease.

Another situation in which CT has a very limited value is in the evaluation of the response to induction therapy, with its most limiting factor being its intrinsic inability to distinguish between a tumour and necrosis. In this context, EUS-FNA has shown to have a good performance, with a sensitivity, negative predictive value and precision of 75%, 67%and 83%, respectively.

In conclusion, EUS-FNA may be considered a good alternative in the pre-operative staging of patients with NSCLC, with and without diseased mediastinal lymph nodes in CT, and could play an important role in the mediastinal re-staging of these patients by identifying a patient sub-group who might benefit from additional surgical treatment.