^(18)F-FDG PET/CT评估鼻咽癌远处间隔转移及诊断效能  

Evaluation of Nasopharyngeal Carcinoma Distant Interval Metastasis and Diagnostic Efficacy by ^(18)F-FDG PET/CT

作　　者：李天然[1] 田嘉禾[1] 赵春雷[2] 陈自谦[2] 王卉[1] 李铭山[2] 王楷堂[2] 

机构地区：[1]解放军总医院核医学科PET/CT中心,北京100853 [2]南京军区福州总医院PET/CT中心

出　　处：《医学研究杂志》2008年第11期39-42,143,共5页Journal of Medical Research

基　　金：国家自然基金项目(30770607)

摘　　要：目的对18F-FDG PET/CT扫描的鼻咽癌病人远处间隔转移情况及医生利用PET/CT诊断鼻咽癌远处间隔转移的效能进行分析。方法75例鼻咽癌分为3组,原发未经治疗组、治疗中组和经治疗组。分析鼻咽癌远各组别远处间隔转移部位、发生率及比较不同组别远处间隔转移发生机会是否有差异。采用5级分类诊断法,选取不同的分级点作为截止点绘制ROC曲线,并寻找最佳截止点评价诊断效能。结果75例鼻咽癌中,原发未经任何治疗的22例,经放射性治疗51例,2例正在治疗中。原发未经治疗组远处间隔转移发生率为59.1%,治疗后组远处间隔转移发生率为68.6%,治疗后组与原发未经治疗组远处间隔转移发生几率比较有统计学意义(P=0.0001)。远处间隔转移最常见的部位依次是远处间隔淋巴结(38.67%)、骨骼(36%)及肝脏(25.33%)。ROC曲线分析表明3为最佳截止点,18F-FDGPET/CT诊断效能较高(敏感性86.36%,特异性88.24%,准确性76.8%)。结论远处间隔转移发生率较高,最常见的部位是远处间隔淋巴结。医生利用PET/CT诊断鼻咽癌远处间隔转移的效能较高。Objective To summarize that the distant interval metastasis of nasopharyngeal carcinoma（NPC） patients who have been examined by ^18F - FDG PET/CT and analysis the diagnostic efficacy of doctors using PET/CT device. Methods 75 patients were divided into three groups including primary patients without any treatment and patients in treating and patients after radiotherapied. The distant interval metastasis sits, incidence and their difference were analyzed. We adopt five grades to diagnose distant interval metastasis of NPC. And we choose the difference grade as cut off point to draw ROC curve and then decide the best diagnostic cut off point. Result There are 22patients in the first group and 2patients in the second group and 51patients in the third group in all 75paients. The incidence of distant interval metastasis in the first group is 59. 1% and third 68.6% and there are statistical significance between groups （P = 0. 0001 ）. The most frequent sites of distant interval metastasis is the distant interval lymph nodes（38.67% ） and the second is skeleton（36% ） and the third is liver（25.33% ）. ROC curve indicate that third one is the best cut off point because of doctors using PET/CT device can acquire the optimal sensitivity（86.36% ） and specificity（88.24% ） and accuracy（76.8% ）. Conclusion The incidence of distant interval metastasis is higher and the most frequent part is distant interval lymph nodes. And the doctors using PET/CT device diagnose the distant interval metastasis of NPC efficacy is higher.

关 键 词：鼻咽癌 PET 转移 FDG 

分 类 号：R739.63[医药卫生—肿瘤] R814.42[医药卫生—临床医学]