Abstract
Background: Lung cancer is the leading cause of death from cancer. The process of staging is critically important for determining prognosis and choosing the optimal therapeutic strategy.
The aim: of this study is to evaluate the diagnostic value of ultrasound and ultrasound guided true cut type needle biopsy (US-TCNB) to diagnose metastatic engaged supraclavicular, cervical and axillarylymph nodes in patients with NSCLC.
Methods: 183 patients with NSCLC (N1 stage 119 and N2 stage 64) without clinical signs of peripheral lymphadenomegaly were enrolled prospectively over a 24 months period. Ultrasound examination was carried out by ultrasound system Philips Envisor XE 11 equipped with linear 5-7.5-12 MHz transducer, Color, Angio and PW Doppler. US-TCNB (18G) was performed on all suspicious for metastatic involvement lymph nodes over 10 mm in size. The biopsy specimens were examined with light microscopy. Immunohistological analysis was carried out when needed.
Results: Sixteen of the 183 patients had suspicious (according to the ultrasound), impalpable peripheral nodes and underwent US-TCNB. Metastatic lymph node involvement was histologically established in 15 of 183 scanned patients (8.2%). One patient had inflammatory type of lymphadenomegaly. As a result of US-TCNB, 15 patients (8.2%) were correctly staged and avoided more invasive diagnostic procedures. No complications were observed.
Conclusion: Ultrasound evaluation and US-TCNB of peripheral lymph nodes are effective and safe techniques for staging of patients with NSCLC.
- Copyright ©the authors 2016