PET/CT对评价非小细胞肺癌纵隔淋巴结转移的诊断价值  

Value of positron emission tomography-computed tomography in the diagnosis of mediastinal lymph node metastasis of non-small cell lung cancer

作　　者：李向东[1,2] 尹吉林[2] 柳伟坤[2] 欧阳习[2] 周崝[2] 乔贵宾[3] 张积仁[1] 

机构地区：[1]南方医科大学珠江医院肿瘤中心,广东广州510282 [2]广州军区广州总医院2PET/CT中心,广东广州510010 [3]广州军区广州总医院2PET/CT胸外科,广东广州510010

出　　处：《南方医科大学学报》2010年第3期506-508,共3页Journal of Southern Medical University

基　　金：卫生部重大科研基金(W2009BX027)

摘　　要：目的探讨PET/CT显像对非小细胞肺癌纵隔淋巴结转移的诊断价值,分析其在肺癌临床分期中的作用。方法收集我院2005年8月至2009年12月进行手术根治或纵隔淋巴结活检的非小细胞肺癌患者158例,所有患者术前均行PET/CT检查,并根据手术或纵隔镜结果进行诊断及分期。对照病理结果,分别计算出CT及PET/CT对诊断纵隔淋巴结转移灶的敏感性、特异性,阳性和阴性预测值及准确性。结果158例患者通过纵隔镜活检及手术切除病理证实的淋巴结共937枚(N1、N2及N3),CT诊断的敏感性、特异性、阳性和阴性预测值分别为51.0%、76.1%、49.0%、77.6%,准确度为68.4%;PET/CT显像的敏感性、特异性、阳性和阴性预测值分别为83.7%、89.0%、77.4%和92.4%,准确度为87.3%。结论PET/CT显示为阳性的淋巴结,有必要行纵隔镜检查,阴性者则可能不需行此项检查。Objective To investigate the value of positron emission tomographic-computed tomographic scanning （PET/CT） in the diagnosis of mediastinal lymph node metastasis in patients with non-small cell lung cancer and the application of PET/CT in the clinical staging of NSCLC. Methods A hundred and fifty-eight patients with NSCLC undergoing surgical resection and mediastinoscopy received preoperative examinations with PET/CT. All the patients underwent mediastinal lymph node dissection or sampling, and the pathological results were compared with the imaging findings. The diagnostic sensitivity, specificity, positive and negative predictive values, and accuracy of CT and PET/CT were compared. Results Final histology was available for 937 lymph node samples （N1, N2, and N3） from 158 patients during mediastinoscopy or surgical resection. The sensitivity, specificity, and positive and negative predictive values of CT for identifying mediastinal lymph node involvement were 51.0%, 76.1%, 49.0%, and 77.6%, respectively, with an diagnostic accuracy of 68.4%. The sensitivity, specificity, and positive and negative predictive values of PET/CT were 83.7%, 89.0%, 77.4%, and 92.4%, respectively, with a diagnostic accuracy of 87.3%. Conclusion Mediastinoscopy is essential for patients with positive findings of mediastinal lymph node involvement by PET/CT, but might not be necessary in negative patients.

关 键 词：脱氧葡萄糖 PET CT 肺肿瘤 

分 类 号：R734.2[医药卫生—肿瘤]