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Objective: To investigate TV mediastinoscopy and CT in mediastinal disease diagnosis and preoperative N staging of lung cancer on value and compare the difference between the two diagnostic methods. Methods: A retrospective analysis of Fujian Medical University Affiliated Union Hospital of Thoracic Surgery, May 2003 to December 2007, after a check of the the clinical the uplink CT or PET-CT diagnosis of mediastinal disease and a high degree of suspicion for lung cancer patients with a total of 68 routine mediastinoscopy endoscopy, line CVM 61 cases, the line PM 7 cases. By TV mediastinoscopy made diagnosis and inspection before diagnosis of CT or PET-CT done compared to determine preoperative postoperative diagnosis of mediastinal disease patients in line with the rate of misdiagnosis rate and CT; of clinical diagnosis for lung cancer patients on television mediastinal biopsy mediastinal lymph nodes, radical resection of lung cancer line thoracotomy line immediately check the results of the N-negative; the N2 of rows neoadjuvant thoracotomy line two courses of chemotherapy after radical resection of lung cancer; N3 give up surgery mainly to chemoradiation therapy. Pathological report \whether the difference in the diagnosis of metastasis. Results: 48 cases of lung cancer patients in this group, the line VM after the results were negative in 31 cases, undergoing open radical resection of lung cancer, N2 14 cases, neoadjuvant thoracotomy line after two courses of chemotherapy lung radical mastectomy N3 three cases, to give up surgery and radiotherapy and chemotherapy in rows mainly. After thoracotomy tuberculoma pathology report two cases, one cases of inflammatory pseudotumor, sclerosing hemangioma, lung cancer, 41 cases; 20 cases of this group of patients with mediastinal disease, line TV mediastinoscopy, diagnosed with large cell carcinoma cases spermatogonia carcinoma, signet ring cell carcinoma, neuroendocrine carcinoma in 1 case, the gastrointestinal malignant gastrointestinal stromal tumor cases, four cases of thymic carcinoma, 3 cases of mediastinal lymph node tuberculosis, mediastinal lymphadenitis cases, 4 cases of sarcoidosis. 2 the mediastinal disease group TVs preoperative mediastinoscopy after diagnosis rate is 55% (11/20), CT misdiagnosis rate is 45% (9/20). Preoperative diagnosis of cases of lung cancer group, the pathology report of 41 cases diagnosed cases of lung cancer for the sample speculate TV mediastinoscopy for lung cancer with mediastinal lymph node metastasis diagnostic sensitivity of 93.3% and a specificity of 100%, 97.6%, authenticity, 100% positive predictive value, negative predictive value of 96.3%; CT for lung cancer with mediastinal lymph node metastasis diagnosis sensitivity 66.7%, specificity of 53.8% and 58.5%, authenticity, positive predictive value 45.5%, negative predictive value of 73.7%, TV mediastinal microscopic examination of the indicators were higher than CT, P lt; 0.05 (XC2 = 4.083), statistically different. Incidence of complications in the study group, 2.94% (2/68), including one case of pneumothorax, closed thoracic drainage was cured cases of recurrent laryngeal nerve injury, did not undergo the treatment and follow-up of 2 months symptoms after treatment. Conclusion: TV mediastinoscopy in diagnosis of mediastinal disease and the high accuracy of the preoperative N staging of lung cancer, is superior to CT; television mediastinoscopy is safe and effective, future broad prospects for development in the field of thoracic surgery.
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