Roman Vereshchako, Ihor Sukhin, Oleksandr Piskorskyi, Roman Gylevych, Yehor Tereshchenko
South Asian Res J Med Sci | Pages : 14-19
DOI : 10.36346/sarjms.2020.v02i03.001
Lung cancer remains the leading cause of cancer mortality and is ranked first on the cancer prevalence against planet's population. The role of cervical mediastinoscopy in determining N status and morphological verification of lung cancer is considered in the article. Material and research methods: The study included 85 patients aged from 19 to 76 years (mean age was 53±13.4 years). Men and women were 47 (55.3%) and 38 (44.7%) respectively. General clinical, laboratory, endoscopic, chest radiography, morphological, immunohistochemical, and statistical methods were used. An indication for mediastinoscopy was the enlargement of the lymph nodes of the mediastinum revealed by thorax computed tomography. Results: The frequency of different combinations in the studied groups of nodes was presented as follows: 2R, 4R, 7 – 16,38%; 4R, 4L, 7 – 21.1%; 4L, 7 – 9,72%; 2R, 4R – 7,73%; 4R, 4L – 6,2%; 4R, 7 – 9,02%; 4R – 2,0%; 10L, 4L, 7 – 2,72%; 2R, 7 – 1,83%; 2R, 2L, 4R, 4L – 4,9%; 2L, 4L, 10L, 4R – 1,16%; 7 – 2,8%; 2R, 4R, 7 – 7,55%; 2R, 4R, 4L, 7 – 5,34%, 4R,10R –1,55%. At 85 patients with enlarged mediastinal lymph nodes on tomography, lung cancer was verified in 42 patients. 43 patients presented with another oncological or non-oncological pathology. In 42 patients, a study of lymph nodes of the mediastinum allowed to verify the diagnosis of lung cancer 25 patients and determine the status of N 17 patients. The sensitivity of cervical mediastinoscopy, compared with computed tomography (CT), was 97.6 CI%95 - [89.3-100.0]. According to chest CT in patients with lung cancer, an increase in mediastinal lymph nodes from 10 to 14.9 mm was observed in 47 (55.3%) people and more than 15 mm in 38 (44.7%) people. The presence of lung cancer metastases in the mediastinal nodes was detected by mediastiniscopy in 33 (78.57%) patients. In 9 (21.43%) cases, mediastinal lymphadenopathy (according to CT data) was not caused by metastasis (false positive). The histological distribution after cervical mediastinoscopy was as follows: squamous cell carcinoma - 10 (21.43%), adenocarcinoma - 24 (57.1%), small cell carcinoma - 8 (19.04%), observations respectively. The results of postoperative histological examination of the mediastinal lymph nodes coincided with the histological results of preoperative cervical mediastinoscopy in 100% of cases (100.0% CI [97.1-100.0]). Conclusions: Cervical mediastinoscopy in patients with primary lung cancer made it possible precisely determine the cause of enlargement of mediastinal lymph nodes and to set the frequency of different combinations of the studied groups of nodes was presented as follows. In patients with primary lung cancer, this method verify the diagnosis in 40.5% of cases and determine N status in 100% of cases. The sensitivity of the cervical mediastinoscopy method, compared with computed tomography, was 96.4% CI [90.8-99.3]. The results of the postoperative histological examination of the mediastinal lymph nodes coincided with the histological results of preoperative cervical mediastinoscopy in 100% of cases.
Professor Aamir Abdullahi Hamza
Editor-in-Chief "South Asian Research Journal of Medical sciences"
Dr. Mohamad Fazli Sabri
Editor-in-Chief "South Asian Research Journal of Business and Management"
Dr. Fatmir Shehu
Editor-in-Chief "South Asian Research Journal of Humanities and Social Sciences"
Dr. Sunil Kumar
Editor-in-Chief "South Asian Research Journal of Agriculture and Fisheries"
Prof. Helme Ahmed Altaee
Editor-in-Chief "South Asian Research Journal of Oral and Dental Sciences"
Dr. Md. Habibur Rahman
Editor-in-Chief "South Asian Research Journal of Pharmaceutical Sciences"
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