Rationale and Objectives
To investigate the clinical value of enlarged mediastinal and/or hilar lymph nodes
on CT for patients with lung subsolid and solid nodules.
Materials and Methods
The study was performed on patients who underwent surgical treatment for suspected
lung cancer. One hundred seventeen subsolid nodules and 101 solid nodules with enlarged
lymph nodes (LNs) were included in the study group. The same number of cases with
normal LNs with a balanced distribution of the clinical T stage were randomly selected
as the control group for each study group. The pathological statuses of the lymph
nodes of these patients proven by histopathology after surgery were collected.
Results
Lung solid lesions with enlarged LNs were more prone to lymph node metastasis (37.6%
vs. 13.9%, p <0.001). However, there were only two and one metastatic lesions in the subsolid
group with and without enlarged LNs, respectively. (2/117 vs. 1/117, p = 1.000). No pathological lymph node metastasis was observed in subsolid lesions
under clinical stage T1b (cT1b), even though some of them (117/234) with enlarged
LNs.
Conclusion
The evaluative significance of enlarged LNs on CT is different for subsolid and solid
lesions. CT is useful for lymph node evaluation and N staging of solid lesions but
may has little value for subsolid lesions. There is a very low possibility of lymph
node metastasis occurring in patients with subsolid lesions under cT1b. Enlarged LNs
on CT may not be critical in subsequent management and treatment for subsolid nodules.
Key Words
Abbreviations:
Enlarged LNs (enlarged lymph nodes (mediastinal and/or hilar lymph nodes)), CT (computed tomography), cT1b (clinical T1b), TNM (Tumor, Node, Metastasis), PET-CT (positron emission tomography-computed tomography), VIF (variance inflation factor), OR (odds ratio), ROC (receiver operator characteristic curve), AUC (area under the curve)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 26, 2022
Accepted:
August 26,
2022
Received in revised form:
August 20,
2022
Received:
July 12,
2022
Publication stage
In Press Corrected ProofFootnotes
This study has received funding by the Natural Science Foundation of Shanghai [Grant Number 21Y11910400].
Identification
Copyright
© 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
