PET／CT鉴别肺癌中胸腔积液性质的临床价值  

Clinical role of F-18 FDG PET/CT in Differentiating Malignant and Benign PleuralEffusion in Patients with Lung Cancer

作　　者：廖日强[1] 杨学宁[1] 王思云[2] 周清[1] 聂强[1] 钟文昭[1] 董嵩[1] 吴一龙[1] 

机构地区：[1]广东省人民医院肿瘤中心肺科、广东省肺癌研究所,广东省医学科学院,广州510080 [2]广东省人民医院核医学科

出　　处：《中国肺癌杂志》2012年第11期652-655,共4页Chinese Journal of Lung Cancer

摘　　要：背景与目的胸腔积液是肺癌患者常见的临床表现,鉴别胸水的性质有重要意义。正电子发射断层扫描/计算机体层摄影(positron emission tomography/computed tomography,PET/CT)是鉴别肺部良恶性肿瘤和纵隔淋巴结分期的重要诊断方法之一。本研究旨在探讨PET/CT鉴别肺癌中胸腔积液性质的临床价值。方法回顾性分析合并胸腔积液的病理确诊的肺癌病例,以病理或临床随访为最后诊断标准,计算PET/CT诊断肺癌恶性胸腔积液的敏感性、特异性、阴性预测值、阳性预测值和准确率。结果33例肺癌患者符合条件纳入分析。PET/CT诊断肺癌恶性胸腔积液的敏感性、特异性、阳性预测值、阴性预测值和准确率分别为81.5%、83.3%、95.7%、50.0%和81.8%。结论PET/CT对鉴别肺癌中胸腔积液的性质具有重要作用,假阳性率低,对PET/CT阴性的胸腔积液,需有创检查确认。Background and objective Pleural effusions, a common feature among patients with lung cancer, should be differentiated into benign or malignant pleural effusions. F-18 fluorodeoxyglucose positron emission tomography/ computed tomography （PET/CT） is one of accurate diagnostic tool for differentiating benign from malignant disease and for mediastinal lymph node staging. We explored the clinical role of PET/CT for differentiating malignant pleural effusion from benign pleural effusion among patients with lung cancer. Methods We retrospectively reviewed the data from all patients with lung cancer and pleural effusion who underwent F-18 FDG PET/CT. The PET/CT results were compared with the pathologic diagnosis or clinical follow-up. The sensitivit~ specifici~, positive predictive value, negative predictive value, and accuracy of PET/CT for detecting malignant pleural metastases were calculated. Results A total of 33 patients were enrolled. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET/CT were 81.5%, 83.3%, 95.7%, 50.0%, and 81.8%, respectively, for detecting malignant pleural effusions lung cancer patients. Conclusion Our results suggest that F-18 FDG PET/CT can play a significant role in diagnosing lung cancer patients with pleural diffusions, with low false-positive rate. However, negative findings under PET/CT should be confirmed through further tests.

关 键 词：PET CT 肺肿瘤 恶性胸腔积液 诊断 

分 类 号：R734.2[医药卫生—肿瘤]