Assessment of Mediastinal Node Involvement by Endoscopic Ultrasonography for Lung Cancer

In 71 patients with lung cancer, preoperative endoscopic ultrasonography (EUS) examination was conducted to evaluate a presence of lymph node metastasis in the mediastinum. The findings of EUS were retrospectively graded in the aspect of (1) the size and the ratio of long/short diameter, (2) the sharpness of the boundary echo, (3) the intensity of the internal echo, and (4) the texture of the internal echo. The scores estimated herein were statistically significant and multiple correlation coefficient was well correlated as being 0.786. When regarding a 0-2 scores as being negative, a 3-4 score as being undetermined and a 5-7 score as being positive, sensitivity was 100%, specficity 95.7%, and overall accuracy was 96.4% according to retrospective analysis. On the other hand, sensitivety was 100%, specificity 93.8% and overall accuracy was 95.2% according to prospective study. When the score of EUS examination was ranging three to four, it was difficult to determine positive node metastasis because there included many cases such as negative metastasis, small metastasis in the part of nodes and positive metastasis in well-differentiated adenocarcinoma. Therefore, it is a limit to evaluation by EUS examination. Nodal involvement in the mediastinum well correlated with a presence of involved #7 node. Therefore, it is of great value to assess a presence of mediastinal node metastasis by evaluating #7 node by EUS examination