氟-18-脱氧葡萄糖正电子发射体层摄影术对胸部恶性肿瘤诊断价值的初步评价  

The initial value evaluation of 18F-fluorodeoxyglucose positron emission tomography in the diagnosis of chest malignant tumors

作　　者：田丰[1] 韩勇[1] 赵正源[1] 杨晔[1] 陈连宏[1] 程庆书[1] 

机构地区：[1]第四军医大学唐都医院胸腔外科,西安710038

出　　处：《中国肺癌杂志》2007年第4期310-312,共3页Chinese Journal of Lung Cancer

摘　　要：背景与目的氟-18-脱氧葡萄糖正电子发射体层摄影术(18F-fluorodeoxyglucose positron emission tomography,18F-FDG PET)被认为是除病理诊断之外对胸部恶性肿瘤最有价值的诊断方法之一。然而在临床工作中,18F-FDG PET诊断同病理诊断不符的病例并不罕见。本研究的目的是对18F-FDG PET在胸部恶性肿瘤诊断中的价值作初步评价。方法收集在西安地区行18F-FDG PET检查,并通过手术、经皮穿刺活检、经支气管镜活检、胸水涂片等方法获得病理诊断的胸部肿瘤患者51例。对比其18F-FDG PET诊断及最终病理诊断的结果,并计算PET对胸部恶性肿瘤诊断的功效率、敏感性、特异性、假阳性率、假阴性率、阳性预示值、阴性预示值。结果18F-FDG PET诊断与最终病理诊断相符合者共34例,其中真阳性31例,真阴性3例。不符者共有17例,其中假阳性11例,病理诊断分别为:结节病2例,肺结核病6例,肺内炎性假瘤2例,肺隐球菌病1例;假阴性6例。计算得出其各项评价指标分别为:功效率66.67%,敏感性83.78%,特异性21.43%,假阳性率78.57%,假阴性率16.22%,阳性预示值73.81%,阴性预示值33.33%。结论18F-FDG PET仍然是目前诊断胸部恶性肿瘤的较为先进的无创检查技术,但其对某些代谢状态较为活跃的良性疾病如结核等,难以与恶性肿瘤相鉴别。因此临床医生必须将PET诊断结果与临床实际相结合,才能最大程度发挥18F-FDG PET在胸部恶性肿瘤诊断方面的优势。Background and objective 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) is considered as one of the most valuable diagnostic methods of chest malignant tumors, except for pathological diagnosis. But in clinic, the cases whose diagnosis of 18F-FDG PET is different from pathological diagnosis are not rare. This study is to evaluate the initial value of 18F-FDG PET in the diagnosis and staging of the chest malignant tumors. Methods Fifty-one cases of chest tumors in Xi’an who underwent 18F-FDG PET were collected. Additionally, pathologic diagnosis had also been experienced on the patients through operation, percutaneous puncture, bronchoscopy or film preparation of pleural fluid. By the comparison of 18F-FDG PET diagnosis and the pathologic diagnosis, accuracy, sensitivity, specificity, false positive rate, positive predictive and negative predictive of 18F-FDG PET were calculated. Results In 51 patients, there were 34 patients whose 18F-FDG PET diagnoses were consistent with the pathological diagnoses, including 31 true positive, 3 true negative. Out of another 17 patients, 11 were false positive, including 2 sarcoidosis, 6 tuberculosis of the lung, 2 inflammatory pseudotumor of the lung and 1 pulmonary cryptococcosis, and 6 were false negative. The calculated values were 66.67% on the overall accuracy, 83.78% on sensitivity, 21.43% on specificity, 78.57% on false positive rate, 16.21% on false negative rate, 73.81% on positive predictive value and 33.33% on negative predictive value. Conclusion Currently, 18F-FDG PET is still one of the most advanced unwounded technologies for the chest malignant tumor diagnosis. However, this technology experiences difficulties in detection of some high metabolized benign disease, such as tuberculosis from malignant tumor. Hence, in order to take advantage of 18F-FDG PET technology and have more accurate diagnosis of chest tumors, both results from the 18F-FDG PET and the clinic actuality should be considered.

关 键 词：正电子发射体层摄影术 胸部恶性肿瘤 诊断 

分 类 号：R730.4[医药卫生—肿瘤]