^18F-氟代脱氧葡萄糖PET／CT与增强CT在结直肠癌区域淋巴结转移诊断价值对比分析  

Comparison of ^18F-FDG PET/CT and enhancement CT in diagnosing regional lymph node metastasis of colorectal cancer

作　　者：王晓燕[1] 饶良俊[1] 易芹芹[1] 陈志丰[1] 李子平[1] 张祥松[1] 史新冲[1] 易畅[1] 

机构地区：[1]中山大学附属第一医院核医学科,广州510080

出　　处：《中华医学杂志》2013年第29期2288-2291,共4页National Medical Journal of China

基　　金：广东省科技计划项目（20128031800082）

摘　　要：目的对比分析^18F-氟代脱氧葡萄糖（^18F-FDG）PET／CT与增强cT诊断结直肠癌区域淋巴结转移的临床运用价值。方法回顾性分析2011年3月至2012年12月中山大学附属第一医院40例结直肠癌患者资料，所有患者均1周内行^18F-FDGPET／CT及增强CT检查，最终经病理检查证实。结果40例结直肠癌患者中，经病理证实20例患者区域淋巴结转移。^18F-FDGPET／CT出现4例假阳性及3例假阴性，^18F-FDGPET／CT诊断结直肠癌淋巴结转移敏感性为85．0％（17／20），特异性为80．0％（16／20），阳性预测值为81．O％（17／21），阴性预测值为84．2％（16／19），准确性为82．5％（33／40）；腹部增强CT出现5例假阳性及8例假阴性，腹部增强CT诊断结直肠癌淋巴结转移敏感性为60．0％（12／20），特异性为75．0％（15／20），阳性预测值为70．6％（12／17），阴性预测值为65．2％（15／23），准确性为67．5％（27／40）；两者假阳性及假阴性经McNemar检验差异无统计学意义（P=0．344），两者敏感性及特异性差异亦无统计学意义（P=0．478，P=0．893；Xz检验）。结论虽然^18F-FDGPET／CT在诊断结直肠癌淋巴结转移方面同增强cT相比有较高的敏感性、特异性及准确性，但差异无统计学意义，因此在临床工作中还需要根据患者情况选择适当的检查方法。Objective The aim of this study was to compare the diagnostic value of lSF-FDG PET/CT with contrast CT for regional lymph node metastasis of coloreetal cancer. Methods Imaging results of 40 patients with colorectal cancer were retrospectively reviewed, and all the patients underwent both abdomen contrast CT and lSF-FDG PET/CT imaging. Final diagnosis was made by histopatbology. Results 20 eolorectal cancer patients were verified with lymph node metastasis while the other 20 patients were absent. Finally, ^18F-FDG PET/CT produced 4 false-positive patients and 3 false-negative patients, is F-FDG PET/CT displayed sensitivity 85.0% （17/20）, specificity 80. 0% （16/20）, positive predictive value 81.0% （17/21 ） , negative predictive value 84. 2% （16/19 ）and accuracy 82. 5 % （33/40）in the diagnosis of lymph node metastasis. Contrast CT produced 5 false-positive patients and 8 false-negative patients. Contrast CT had the sensitivity 60. 0% （ 12/20 ）, specificity 75.0% （ 15/20 ）, positive predictive value 70. 6% （12/17）, negative predictive value 65.2% （15/23） and accuracy 67.5% （27/40）. Sensitivity and specificity of PET/CT was better than of contrast CT, but no statistically significant difference between PET/CT and contrast CT （ P = 0. 478, P = 0. 893 ; P = 0. 344. Fisher＇ s exact test and MeNemar test ）. Conclusion Sensitivity and specificity of PET/CT was better than of contrast CT, but no statistically significant difference. Clinical works also need to select the appropriate inspection methods based on the patient＇s situation.

关 键 词：结直肠肿瘤 正电子发射断层显像术 体层摄影术 x线计算机 诊断 

分 类 号：R735.3[医药卫生—肿瘤]