^(18)F-FDG PET/CT在寻找颈淋巴结转移瘤原发灶中的应用价值  

^(18)F-FDG PET /CT for the detection of primary tumors metastasizing to lymph nodes of the neck

作　　者：胡莹莹[1,2] 梁培炎[1,2] 林晓平[1,2] 张旭[1,2] 张伟光[1,2] 樊卫[1,2] 

机构地区：[1]华南肿瘤学国家重点实验室,广东广州510060 [2]中山大学肿瘤防治中心核医学科,广东广州510060

出　　处：《癌症》2009年第3期312-317,共6页Chinese Journal of Cancer

摘　　要：背景与目的:颈部淋巴结转移瘤在颈部恶性肿瘤中最常见,原发灶检出与否直接影响患者的生存期和生活质量。本研究旨在评估18F-FDGPET/CT在寻找颈淋巴结转移瘤原发灶中的应用价值;另外,设定不同的PET/CT原发灶诊断标准,分别评价其阳性预测价值。方法:对93例病理学诊断为颈淋巴结转移瘤的患者行18F-FDGPET/CT显像,根据不同的PET/CT原发灶诊断标准寻找原发灶,即明确诊断、可疑诊断及未见原发灶征象;所有PET/CT诊断均与病理或其它影像检查相对照。结果:PET/CT明确诊断原发灶40例,均经病理或临床证实,阳性预测值100%;PET/CT可疑诊断28例,经病理证实为原发灶16例,其阳性预测值57.1%;2例患者经PET/CT提示为纵隔淋巴结转移但未见原发灶征象,最终临床诊断为原发纵隔型肺癌;2例患者PET/CT未见原发征象,经内窥镜检出原发灶;PET/CT原发灶检出率为60.2%(56/93)。结论:18F-FDGPET/CT在寻找颈淋巴结转移瘤原发灶中有较大的临床价值。Background and Objective. Lymph node metastases are commonly seen in malignant tumors of the head and neck. Detection of the primary tumors affects the quality of life and survival rates of these patients. This study was to evaluate the application of ^18F-FDG PET/CT in detecting primary tumors metastasizing to lymph nodes of the neck, and to assess the positive predictive value of ^18F-FDG PET/CT. Methods. In total 93 patients with pathologically confirmed neck lymph node metastases from unknown primary tumors underwent ^18F-FDG PET/CT in Sun Yat-sen University Cancer Center between June 2005 to April 2008 were entered into this study. The primary tumors of patients were initially diagnosed according to different PET/CT standards as definite diagnosis, suspicious diagnosis and no signs of primary tumors. All diagnosis based on PET/CT images were verified by pathological exams or additional imaging tests. Results. Forty cases made definite diagnosis by PET/CT were all confirmed by pathological or clinical exams, with a positive predictive value of 100%. Of 28 cases made suspicious diagnosis, 16 were pathologically confirmed, with a positive predictive value of 57.1%. Two patients, who were suggested lymph node metastases in mediastinum without the sign of the primary tumor by PET/CT, were clinically verified as primary mediastinal lung cancer. The primary tumors of another two patients were not detected by PET/CT, but were found under endoscopy. The total detection rate of PET/CT for the primary tumor was 60.2% （56/93）. Conclusion. PET/CT is of important clinical value in detecting primary tumors metastasizing to lymph nodes of the neck.

关 键 词：淋巴转移 氟脱氧葡萄糖F18 体层摄影术 X线计算机 肿瘤 原发灶 诊断 

分 类 号：R730.4[医药卫生—肿瘤]