Evaluation of lymph nodes on computed tomography images in epidermoid lung cancer

This study was undertaken to design the optimal criteria for practical guidelines for lymph node metastasis evaluation in epidermoid lung cancer. Resected lymph nodes (n = 214) were analyzed by preoperative computed tomography (CT) images and postoperative histopathological findings. Definite criteria were defined by efficiency, and possible criteria by receiver operating characteristic (ROC) analysis. Statistical values of highest efficiency in 214 lymph nodes revealed that the minor axis offered the best criteria (minor axis 13 mm; efficiency 93%). ROC curve using the minor axis which showed the highest values of sensitivity and specificity in the optimal criteria (minor axis 9.3 mm; sensitivity 76%, specificity 76%). The criteria of the paratracheal lymph nodes were smaller than those of tracheobronchial and subcarinal nodes. In conclusion, it is desirable to evaluate metastasis of lymph nodes by the minor axis, and criteria should be considered changeable to accommodate the anatomical location in epidermoid lung cancer.