^(18)氟-脱氧葡萄糖双探头符合线路显像诊断非小细胞肺癌胸内淋巴结转移  

Lymph Node Metastasis Diagnosis Using ^(18)F-Fluorodeoxyglucose Coincidence PET/CT in Non-small Cell Lung Cancer

作　　者：倪剑[1] 陈斌[1] 龚忠义 付钦卿 钟彝璞 唐恭顺[3] 

机构地区：[1]简阳市人民医院核医学科,四川简阳641400 [2]简阳市人民医院技术科教部,四川简阳641400 [3]四川大学华西医院核医学科

出　　处：《华西医学》2013年第2期161-165,共5页West China Medical Journal

基　　金：国家自然科学基金(30970859)~~

摘　　要：目的探讨18氟-脱氧葡萄糖(18F-FDG)双探头符合线路对非小细胞肺癌胸内淋巴结转移的诊断价值,并分析其假阳性、假阴性诊断的原因。方法回顾性分析2010年12月-2012年6月非小细胞肺癌患者161例的临床资料,其中腺癌122例,鳞癌23例,其他类型16例。分析患者术前18F-FDG双探头符合线路显像对肺门、纵膈淋巴结的诊断结果(其中阳性53例,阴性108例),以术后病理诊断为金标准,评价其诊断价值。分析9例假阳性、26例假阴性诊断患者的吸烟史、慢性支气管炎肺气肿、肺结核病史、局限性肺炎、肿瘤标志物、淋巴结短径、肿瘤原发灶T/N比值、外周血白细胞等指标。结果 18F-FDG双探头符合线路单光子发射计算机断层成像(SPECT)诊断非小细胞肺癌淋巴结转移的灵敏度、特异性、准确性、阳性预测值、阴性预测值分别是62.9%、90.1%、78.3%、83%、75.9%。假阳性组患者慢支炎肺气肿、局限性肺炎者高于真阳性组。假阴性组的淋巴结短径、原发灶T/N比值小于真阳性组。结论 18F-FDG双探头符合线路SPECT是术前诊断肺癌淋巴结转移的有效手段;假阳性淋巴结与慢支炎肺气肿、局限性肺炎有关;假阴性淋巴结与淋巴结短短径小、原发肿瘤摄取18F-FDG低有关。Objective To analyze the diagnostic ability of 18F-fluorodeoxyglucose（18F-FDG） coincidence positron emission tomography（18F-FDG Co-PET） for lymph node（LN） metastasis in non-small cell lung cancer（NSCLC） by focusing on the clinical features of false-positive（FP） and false-negative（FN） cases.Methods From January 2011 to March 2012,161 patients with NSCLC were treated,including 122 cases of adenocarcinoma,23 cases of squamous cell carcinoma,and 16 cases of other types.We analyzed the diagnostic results of 18F-FDG Co-PET on hilus of lung and mediastinal lymph node,and assessed its diagnostic value based on postoperative pathology.For the nine FP and 26 FN patients,we analyzed their smoking history,chronic obstructive pulmonary disease（COPD）,pulmonary tuberculosis history,segment pneumonia,tumor markers,short-axis size of LN,primary tumor T/N ratio,and peripheral blood leukocytes.Results Based on the Co-PET/CT results,35 patients were misdiagnosed（26 FN and 9 FP）.The sensitivity,specificity,accuracy,negative and positive predictive values were 62.9%,90.1%,78.3%,83%,75.9% respectively.FP findings more frequently occurred in patients with COPD,and segment pneumonia.In the FN group,the T/N ratio for primary tumor was lower than that in the true positive（TP） group.The short–axis size of LNs was significantly smaller in the FN group than that in the TP group,whereas there was no difference between TP and FP.Conclusions Co-PET/CT shows a good ability in detecting metastatic LNs of non-small cell lung cancer.However,there are some limitations,especially in patients with COPD and segment pneumonia.

关 键 词：非小细胞肺癌 18氟-脱氧葡萄糖 双探头符合线路 淋巴结 

分 类 号：R734.2[医药卫生—肿瘤]