用ROC曲线法分析^(99)Tc^m-HL91肺肿瘤阳性显像的诊断效能  

The diagnosis ability of positive ^(99)Tc^m-HL91 imaging in pulmonary tumors analysed by ROC curve

作　　者：邓惠兴[1] 杨爱民[1] 冉宏德[1] 程虎[1] 高信耀[1] 刘敏[1] 

机构地区：[1]西安交通大学第一医院核医学科,710061

出　　处：《中华核医学杂志》2004年第6期330-332,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的　探讨半定量分析及接受器工作特性 (ROC)曲线法在99Tcm 4 ,9 二氮 3,3,10 ,10 四甲基十二烷 2 ,11 二酮肟 (HL91)肿瘤阳性显像鉴别肺部良恶性肿块中的价值。方法　经CT检查发现肺部肿块的患者 5 0例 ,均经活组织检查或手术病理检查证实。根据病理检查结果分为恶性组 37例和良性组 13例。术前行99Tcm HL912h、4h平面显像及 4h断层显像 ,分别使用视觉判断法、半定量分析及ROC曲线法分析显像结果。结果　①视觉判断法 :99Tcm HL91显像的灵敏度、特异性和准确性分别为 97 3%、6 9 2 %和 90 0 %。②肿瘤 正常肺组织 (T N)比值半定量分析及ROC曲线法 :恶性组 2h、4h平面显像及 4h断层显像T N比值分别为 1 5 2± 0 19、1 73± 0 2 8及 2 84± 0 97;良性组分别为1 2 0± 0 16、1 2 4± 0 2 0及 1 5 2± 0 4 0。各个时相的曲线下面积分别为 0 90 9± 0 0 5 6、0 94 5± 0 0 39、0 95 3± 0 0 34。从99Tcm HL91断层显像ROC曲线的界值点找到 1个界点 (T N =1 76 ) ,以其作为判断良、恶性的诊断阈值 ,灵敏度、特异性和准确性分别为 10 0 %、84 6 %和 96 0 %。③视觉判断法与半定量分析法比较 :T N比值半定量分析及ROC曲线法使诊断的灵敏度、特异性和准确性都有提高 ,尤其特异性。但两种方法?Objective To evaluate the diagnosis value of positive 99Tcm-4,9-diaza-3,3,10,10-tetramethyldodecan-2,11-dione dioxime (HL91) imaging using receiver operating characteristic (ROC) curve for distinguishing the character of pulmonary neoplasms. Methods Fifty patients with pulmonary neoplasms diagnosed by spiral CT were selected. All patients were verified by biopsy or surgery, and divided into benign and malignant group. 2 h, 4 h planar and 4 h tomography imaging were done in all patients using 99Tcm-HL91. Visual and semiquantitative methods were used to analyse the images. The diagnosis ability was analysed by ROC curve. Results ①Visual analysis: the sensitivity, specificity and accuracy of 99Tcm-HL91 imaging were 97.3%, 69.2% and 90.0%, respectively. ②Semiquantitative analysis: in 37 malignant patients, the ratio of T/N was 1.52±0.19 on 2 h planar imaging, 1.73±0.28 on 4 h planar imaging and 2.84±0.97 on 4 h tomography imaging. In benign group, they were 1.20±0.16, 1.24±0.20 and 1.52±0.40, respectively. The area under the ROC curve of corresponding phase was 0.909±0.056, 0.945±0.039 and 0.953±0.034, respectively. A threshold (T/N=1.76) was gained from ROC curve of 4 h tomography phase and was used to distinguish the character of the pulmonary neoplasms. The sensitivity, specificity and accuracy were 100%, 84.6% and 96.0%, respectively. ③Comparison of the results of visual and semiquantitative analysis: the sensitivity, specificity and accuracy of semiquantitative analysis were higher than those of visual analysis, especially the specificity, but there was no statistical difference (P>0.05). Conclusions Using of ROC curve and semiquantitative analysis can provide a diagnosis threshold for judging the character of pulmonary neoplasms (4 h tomography phase T/N=1.755). It also can improve the diagnosis capability of 99Tcm-HL91 imaging.

关 键 词：诊断 ROC曲线 ^99TC^M-HL91 阳性 断层显像 肿瘤 恶性 平面 准确性 结论 

分 类 号：R734.2[医药卫生—肿瘤] R737[医药卫生—临床医学]