[Evaluation of scalene lymph node or contralateral mediastinum biopsy during mediastinoscopy for non-small cell lung cancer].
OBJECTIVE
To explore the clinical indication of N3 lymph node biopsy during mediastinoscopy for non-small cell lung cancer (NSCLC).


METHODS
Cervical mediastinoscopy was performed in 89 patients with clinical stage I-IIIA non-small cell lung cancer prior to thoracotomy. Of those, 12 underwent cervical medistinoscopy combined with right scalene lymph node biopsy and 10 with anterior mediastinotomy.


RESULTS
Nine patients were found to have lymph node metastasis (N3 disease) during mediastinosopy. Of those, 6 had contralateral mediastinal lymph node metastasis and 3 cases with right scalene lymph node metastasis. The incidence of N3 disease in the patients with adenocarcinoma, serum CEA > 5 ng/ml and multi-station mediastinal lymph node metastasis was significantly higher than that in those with non-adenocarcinoma, CEA < 5 ng/ml and ipsilateral uni-station mediastinal lymph nodes metastasis (P < 0.05).


CONCLUSIONS
Biopsy of scalene lymph node or contralateral mediastinal lymph node should be performed during mediastinoscopy in order to exclude N3 disease for potentially operable NSCLC patients with adenocarcinoma, serum CEA >5 ng/ml and ipsilateral multi-station mediastinal lymph nodes metastasis.
Yu
Hui
H
State Key Laboratory of Oncology in Southern China, Department of Thoracic Surgery, Cancer Center, Sun Yat-sen University, Guangzhou 510060, China.
Zhang
Shi-yi
SY
Wang
Xin
X
Xie
Ze-ming
ZM
Wang
Jun-ye
JY
Li
Yong
Y
Xie
Xuan
X
Zhou
Jia-liang
JL
Zhang
Lan-jun
LJ
Fu
Jian-hua
JH
D000230:Adenocarcinoma / Q000097:blood / Q000473:pathology*; D000328:Adult; D000368:Aged; D001706:Biopsy; D002272:Carcinoembryonic Antigen / Q000097:blood; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000473:pathology*; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008481:Mediastinoscopy; D008482:Mediastinum; D008875:Middle Aged; D009334:Neck Muscles; D009367:Neoplasm Staging
D002272:Carcinoembryonic Antigen