^18F-FDG双探头符合线路单光子发射计算机体层摄影术-计算机体层摄影术在肺癌诊断与分期中的应用  

The role of ^18F-FDG DHC SPECT-CT in the diagnosis and staging for lung cancer

作　　者：毛友生[1] 赫捷[1] 郑容[2] 林琳[2] 刘琳[2] 陈钊[2] 

机构地区：[1]中国医学科学院肿瘤医院科胸外科,北京100021 [2]中国医学科学院肿瘤医院核医学科,北京100021

出　　处：《中华肿瘤杂志》2008年第12期933-936,共4页Chinese Journal of Oncology

摘　　要：目的评价^18F—FDG双探头符合线路单光子发射计算机体层摄影术-计算机体层摄影术（SPECT-CT）在肺癌患者诊断与分期中的临床应用价值。方法对71例肺内病变怀疑肺癌患者进行SPECT-CT和常规CT检查。共57例患者获得病理或细胞学证实，其中52例为肺部恶性肿瘤，5例为肺部良性病变。37例患者有完整病理分期资料。结果以病理诊断为金标准，SPECT—CT诊断肺内病变的敏感性、特异性和准确率分别为92．3％、80．0％和91．2％，常规CT分别为84．6％、80．O％和84．2％，两种检查方法诊断准确率差异无统计学意义（P=0．254）。以病理分期为金标准，SPECT／CT的TNM分期准确率为67．6％，常规CT为59．5％，两种检查方法诊断准确率差异无统计学意义（P=0．469）。SPECT-CT对肺门及纵隔淋巴结诊断的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为61．5％、75．0％、70．3％、57．1％和78．3％，而常规CT分别为76．9％、79．2％、78．4％、66．6％和86．4％，两种检查方法诊断准确率差异无统计学意义（P=0．425）。结论SPECT-CT在肺部病变良恶性判断和分期方面略优于常规CT，可以用于一部分患者病变的良恶性鉴别和直径≥1cm淋巴结性质的判断。Objective To investigate and compare the clinical significance of ^18F-FDG singlephoton emission computed tomography and computed tomography （SPECT-CT） in the diagnosis and staging of lung cancer. Methods From July 2005 to July 2007, 71 patients with suspected lung cancer received conventional CT and SPECT-CT examination. Fifty-seven of the 71 patients had definite pathological or cytological diagnosis, consisting of 52 malignant lung tumors and 5 benign pulmonary nodules. Forty-three patients underwent surgical resection with different modes. Thirty-seven of the 43 surgically treated patients had available complete data of CT, SPECT-CT and pathological results. Results Taking the pathological diagnosis as gold standard, the sensitivity, specificity and accuracy of diagnosing pulmonary lesions suspected as lung cancer were 84.6% （44/52）, 80.0% （4/5）, 84.2% （48/57） for conventional CT and 92.3% （48/52） ,80.0% （4/5） ,91.2% （ 52/57 ） for SPECT-CT, respectively. If taking the pathological TNM staging results as gold standard, the concordance rates of TNM staging with pathological TNM staging results was 59.5% （22/37） for CT and 67.6% （25/37） for SPECT-CT. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of staging hilar and mediastinal lymph nodes were 76.9% ,79.2% ,78.4% ,66.6% ,86.4% for conventional CT versus 61.5% ,75.0% ,70. 3% ,57.1%, 78.3% for SPECT-CT （ P 〉 0.05）, respectively. There was no statistically significant difference between conventional CT and SPECT-CT in the accuracy of diagnosing and staging for the suspected pulmonary lesions （P 〉 0.05）. Conclusion SPECT-CT is likely superior to conventional CT in the diagnosing and staging for lung cancer. It can be used as a non-invasive supplementary tool for differential diagnosis between malignant and benign pulmonary lesions and in diagnosis of lymph node 〉 1 cm in diameter.

关 键 词：肺肿瘤 体层摄影术 发射型计算机 单光子 TNM分期 

分 类 号：R686[医药卫生—骨科学]