• Xin Wang, Lie Zheng, Li Ling, Shi-yi Zhang, Ze-ming Xie, Hui Yu, Xiao-dong Su, Jun-ye Wang, Zhi-fan Huang, Ming-tian Yang, and Tie-hua Rong.
• Department of Thoracic Surgery, Cancer Center, Sun Yet-sen University, Guangzhou 510060, China.
• Zhonghua Zhong Liu Za Zhi. 2009 Jan 1;31(1):42-4.

ObjectiveTo compare the value of CT and mediastinoscopy in assessment of mediastinal lymph node status in potentially operable non-small cell lung cancer (NSCLC).MethodsFrom Oct. 2000 to Jun. 2007, 152 consecutive patients with pathologically proven and stage I to approximately III NSCLC were enrolled into the study. Of the 152 cases, there were 118 males and 34 females, with a median age of 58 years (range, 24 to approximately 79 years). Compared with the final pathology, the sensitivity, specificity, positive and negative predictive values and accuracy of CT and mediastinoscopy for preoperative evaluation of mediastinal lymph node status were calculated, respectively. The accuracy and diagnostic efficacy of CT and mediastinoscopy was compared by Pearson chi(2) test and ROC curve, respectively.ResultsThe sensitivity, specificity, positive predictive value, negative predictive value and accuracy of detection of mediastinal metastasis was 73.8%, 70.1%, 64.9%, 78.2% and 71.7% by CT, respectively, versus 83.1%, 100.0%, 100.0%, 88.8% and 92.8% by mediastinoscopy, respectively. Both the accuracy and diagnostic efficacy of mediastinoscopy were superior to CT (Pearson chi(2) test, P < 0.001; Z test of the areas under the ROC curve, P < 0.001). The complication rate of mediastinoscopy was 4.6%, and the false negative rate was 7.2%.ConclusionMediastinoscopy is safe and effective in preoperative assessment of mediastinal lymph node status in potentially operable NSCLC, while CT alone is inadequate.

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