^(18)F-FDGPET/CT评价肺癌纵隔淋巴结转移的准确性  

Accuracy of ^(18)F-FDG PET/CT in Evaluating Mediastinal and Hilar Lymph Node Metastasis of Lung Cancer

作　　者：王剑杰[1] 陈燕[1] 李立伟[2] 

机构地区：[1]武警总医院核医学科,北京100039 [2]空军总医院核医学科,北京100142

出　　处：《中国医学影像学杂志》2015年第3期204-208,共5页Chinese Journal of Medical Imaging

摘　　要：目的探讨18F-FDG PET/CT显像在评价肺癌纵隔淋巴结分期中的价值,为外科手术提供指导。资料与方法回顾性分析经手术病理证实的78例肺癌患者,以病理结果为"金标准",与同期胸部CT对比,分析18F-FDG PET/CT对肺癌纵隔淋巴结转移的诊断效能。结果 78例患者进行常规肿瘤切除及纵隔肺门淋巴结清扫,其中18例患者共清扫淋巴结231枚,发现转移淋巴结105枚(45.5%),其余60例患者清扫的淋巴结病理未见转移。依据病理结果,78例患者的淋巴结病理分期(p N)为:18例患者中,5例为p N1,11例为p N2,2例为p N3;其余60例患者分期为p N0。18F-FDG PET/CT诊断纵隔淋巴结分期的灵敏度、特异度、准确度、阳性预测值与阴性预测值分别为80.9%、94.7%、91.0%、85.0%、93.1%,同期胸部CT分别为61.1%、71.7%、69.2%、39.2%、86.0%,两者差异有统计学意义(χ2=4.325,P<0.05)。结论 18F-FDG PET/CT诊断肺癌淋巴结分期有较高的准确性和阴性预测值,优于胸部常规CT扫描,可为外科手术方式的选择提供科学依据。PurposeTo investigate the accuracy of ^18F-FDG PET/CT in diagnosing mediastinal and hilar lymph node metastasis of lung cancer and in guiding surgery. Materials and Methods Seventy-eight pathology-proven lung cancer patients underwent ^18F-FDG PET/CT scanning and surgery. Histology was used as gold standard to evaluate the diagnosis of mediastinal and hilar lymph node metastasis.^18F-FDG PET/CT was also compared to chest CT.Results The pathological examination confirmed metastasis lymph nodes in 105 out of 231 excised lymph nodes in 18 patients. No lymph node metastasis was found in mediastinum in the other 60 patients with lymph node staging of pN0. Lymph node staging was pN1 in 5 patients, pN2 in 11 patients, and pN3 in 2 patients. In all 78 cases, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of18F-FDG PET/CT were 80.9%, 94.7%, 91.0%, 85.0%, 93.1%; while 61.1%, 71.7%, 69.2%, 39.2%, 86.0% on chest CT. These were statistically different （χ^2=4.325,P〈0.05）.Conclusion PET/CT is superior to plain chest CT examination as an accurate and efficient method in evaluating lymph nodes staging of lung cancer.

关 键 词：肺肿瘤 纵隔 淋巴结 肿瘤转移 正电子发射断层显像术 体层摄影术 X线计算机 氟脱氧葡萄糖F18 肿瘤分期 

分 类 号：R734.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]