Noninvasive Staging of Non-small Cell Lung Cancer: ACCP Evidenced-Based Clinical Practice Guidelines (2nd Edition)

摘要: Background Correctly staging lung cancer is important because the treatment options and prognosis differ significantly by stage. Several noninvasive imaging studies including chest CT scanning positron emission tomography (PET) are available. Understanding test characteristics of these critical to decision making. Methods Test for were updated from first iteration guidelines using systematic searches MEDLINE, HealthStar, Cochrane Library databases up May 2006, selected metaanalyses, practice guidelines, reviews. Study designs results summarized in evidence tables. Results The pooled sensitivity specificity identifying mediastinal lymph node metastasis 51% (95% confidence interval [CI], 47 54%) 85% CI, 84 88%), respectively, confirming that has limited ability either rule or exclude metastasis. For PET scanning, estimates 74% 69 79%) 82 respectively. These findings demonstrate more accurate than scanning. If clinical evaluation search metastatic disease negative, likelihood finding low. Conclusions useful providing anatomic detail, but accuracy differentiating benign malignant nodes mediastinum poor. much better mediastinum, distant can be detected With test, abnormal must confirmed tissue biopsy ensure staging.