Komparativna analiza parametara višeredne kompjuterizovane tomografije i patohistoloških nalaza kod karcinoma pluća

Abstract

COMPARATIVE ANALYSIS OF PARAMETERS FOR MULTI-SLICE COMPUTED TOMOGRAPHY AND HISTOPATHOLOGICAL FINDINGS IN LUNG CANCER

AIM: The main aim of this research is to demonstrate that the MSCT is a modality of choice, the ''gold standard'' for diagnosis and staging of lung cancer. Comparison of CT findings with histopathologically confirmed TNM stage confirmed also ability of this imaging modality in determination of morphological characteristics of certain histologic types of lung cancer. PATIENTS AND METHODS: This research represents a prospective - retrospective study of patients with lung cancer. A total of 173 patients with histologically confirmed NSCLC and SCLC were included. In the interest of the study, and to facilitate statistical analysis, all patients were divided into two groups: operable (117) and inoperable (56). We analyzed the CT morphological characteristics of lung cancer as well as demographic characteristics. RESULTS: Mean age of the participants was 60.2 ± 8.7 years. With regard to smoking status, the majority were smokers, the period of smoking was over 20 years, but in relation to duration and intensity of smoking patient were divided into three groups: smokers who smoked more than 20 years and more than a pack per day - 49.13%, smokers who smoked more then 20 years and a pack per day – 5.78% and group of smokers who smoked more than 20 years but intermittently - 15.61%. Occupational exposure is positive in 16.18% of patients, while a positive family history is present in 20.81% of patients. The most common type of cancer is adenocarcinoma 40.46%, followed by squamous cell carcinoma 34.68%. The sensitivity of MSCT imaging modality in T staging of lung cancer, taking pathohistological results as reference value, ranges from 72.73% to 99.8% and specificity ranges from 94% to 99.3%, while the global accuracy ranges from 97.43% to 98.29%. The sensitivity of MSCT in N staging of lung cancer ranges from 68.7% to 71%, the specificity was higher ranging from 92.3 to 94.1%, while the global accuracy ranges from 85.3% to 86.1%. CONCLUSION: In our study, we confirmed that MSCT is the ''gold standard'' in the 11 preoperative staging of patients with lung cancer. Multi detector computerized tomography provides detailed information not only on tumor size but also provides information on morphological characteristics of tumor.