title: Lymphatic microvessel density combined with CT used in the diagnosis of mediastinal and hilar lymph node metastasis of non-small cell lung cancer.
abstract: OBJECTIVE
  Lymphatic microvessel density (LMVD) has been demonstrated to correlate with tumor metastasis. The purpose of this study is to determine whether the criteria combining LMVD with computed tomography (CT) could improve the diagnostic accuracy of lymph node (LN) metastasis in non-small cell lung cancer (NSCLC).
  
  
  METHODS
  Ninety four patients with NSCLC who had chest CT scans preoperatively and LMVD tested by immunohistochemistry postoperatively were randomized into two groups: the training set (n = 66) and the test set (n = 28). Cut-off point of LMVD was selected to separate the LN metastasis-predictive positive and negative groups. On the basis of LMVD levels, chest CTs of the training set were re-analyzed and hypothetical criteria for LN metastasis diagnosis were established. Diagnostic characteristics for LN metastasis were tested by using the combined criteria in the test set as compared to those of CT alone.
  
  
  RESULTS
  There was a significantly positive correlation between LMVD and LN metastasis (p <0.01). For sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV), accuracy was 67, 81, 75, 81 and 79% for the combined criteria, respectively. Diagnostic efficacy of the combined criteria was significantly higher than that of CT only (p <0.05).
  
  
  CONCLUSIONS
  Diagnosis of LN metastasis using a combination of LMVD and CT is superior to the CT-only diagnosis. In future clinical trials, it is necessary to evaluate the efficacy of adjuvant therapy for the selection of patients according to the combined criteria.
authors.affiliation: Department of Radiology, Xiang Ya Hospital, Central South University, Changsha, Hunan, PR China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhou
authors.forename: Jin-Kang
authors.initials: JK
authors.lastname: Liu
authors.forename: Shen-Xi
authors.initials: SX
authors.lastname: Chen
authors.forename: Zeng
authors.initials: Z
authors.lastname: Xiong
authors.forename: Guo-Qiang
authors.initials: GQ
authors.lastname: Lin
authors.forename: Mo-Ling
authors.initials: ML
authors.lastname: Zhou
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: Yang-Teng-Yu
authors.initials: YT
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D042601:Lymphatic Vessels / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*