Abstract
Objective. To optimize the diagnostic algorithm in mediastinal lymphadenopathy in patients with pulmonary cancer, using modern diagnostic methods.
Materials and methods. Into the investigation 106 patients with pulmonary gland cancer, ageing from 19 to 81 yrs old, were included. In all the patients the enlarged mediastinal lymph nodes were diagnosed, using CT, and in some – using PET with simultaneous CT. In the next stage cervical mediastinoscopy was performed (86 patients) or EBUS-TBNA (20 patients). In 29 patients radical operation for the lymph nodes excision was performed.
Results. Sensitivity and specificity of PET, performed simultaneously with CT, versus CT have constituted 74.3 and 80.2% and 54.6 and 74.7%, accordingly. Accuracy of invasive method of EBUS-TBNA have constituted 87.5%. Sensitivity, specificity and accuracy of cervical mediastinoscopy have constituted 97.6, 98.9 and 96.7% accordingly.
Conclusion. On the first stage of examination it is expedient to use CT and PET with simultaneous CT. EBUS-TBNA has great part of false-negative results. Cervical mediastinoscopy constitutes the most specific, sensitive and highly accurate diagnostic method for mediastinal lymphadenopathy.