PET/CT对卵巢恶性肿瘤淋巴转移的诊断价值  

Diagnostic value of PET/CT for lymph node metastasis of ovarian malignant tumor

作　　者：王婷婷[1] 翟建军[1] 

机构地区：[1]首都医科大学附属北京同仁医院妇产科,北京100730

出　　处：《中国临床研究》2015年第11期1436-1438,共3页Chinese Journal of Clinical Research

基　　金：北京市教育委员会科技计划资助项目(KM201410025029)

摘　　要：目的 探讨正电子发射计算机断层显像（PET/CT）在诊断卵巢恶性肿瘤淋巴转移中的临床价值。方法 选取2011年1月至2014年12月期间收治的104例卵巢恶性肿瘤患者为研究对象,采用PET/CT检查对所有患者腹膜后淋巴结、腹主动脉旁淋巴结、盆腔淋巴结转移及浅表淋巴结转移的位置和状况进行评价。初次治疗患者行卵巢癌肿瘤细胞减灭术联合腹膜后淋巴结清扫术,复发患者行区域和病灶淋巴结清扫术。以术后淋巴结病理检查结果为标准,计算PET/CT对卵巢恶性肿瘤淋巴结转移诊断的特异性、敏感性、准确性、阴性预测值和阳性预测值。结果 以术后病理检查结果为标准,PET/CT显像诊断卵巢恶性肿瘤患者盆腔淋巴结转移的敏感性90.91%、特异性95.12%、准确性94.23%、阳性预测值83.33%和阴性预测值97.50%;诊断腹主动脉旁淋巴结转移的敏感性96.30%、特异性100.00%、准确性98.08%、阳性预测值100.00%和阴性预测值96.15%;诊断腹膜后淋巴结转移的敏感性96.30%、特异性92.00%、准确性94.23%、阳性预测值92.86%和阴性预测值95.83%。PET/CT显示体检阴性的左锁骨上淋巴结转移4例,腋窝淋巴结转移4例,淋巴结大小1.0～1.2 cm,均经术后病理证实。结论PET/CT检查是术前判断卵巢恶性肿瘤是否发生淋巴结转移的重要手段,对淋巴结转移的诊断有较高的临床价值,对卵巢恶性肿瘤的治疗有重要指导意义。Objective To explore the clinical value of positron emission computed tomography （PET/CT） in the diagno- sis of lymph node metastasis of ovarian cancer. Methods A total of 104 patients with ovarian cancer treated between Janu- ary 2011 and December 2014 were selected in this study. PET/CT was used to detect and evaluate the positions and status of metastases of retroperitoneal lymph nodes, para-aortic lymph nodes, pelvic lymph nodes and superficial lymph nodes. The patients of initial treatment were treated with ovarian cancer eytoreductive surgery （CRS） and retroperitoneal lymph node dissection. Recurrent patients were treated with regional and focus lymph node dissection. According to the results of patho- logical examination,the specificity, sensitivity, accuracy, positive and negative predictive values of PET/CT for diagnosing lymph node metastasis of ovarian cancer were calculated and analyzed. Results Taking the results of pathological examina- tion after operation as a standard,the specificity,sensitivity, accuracy, and positive and negative predictive values of PET/ CT for diagnosing pelvic lymph node metastasis of ovarian malignant tumor were 90.91% ,95.12% ,94.23 % ,83.33 % and 97.50% , respectively. The specificity, sensitivity, accuracy and positive and negative predictive values for diagnosing para- aortic＇, lymph node metastasis were 96.30% 100.00% ,98.08% , 100.00% and 96.15% ,respectively. The specificity, sen- sitivity,aceuracy and positive and negative predietive values tbr diagnosing retroperitoneal lymph node metastasis were 96. 30% ,92.00% ,94.23% ,92.86% and 95.83% , respectively. In the patients with negative results of physical examina- tion, PET/CT found left supraclavicular lymph node metastasis in four cases and axillary, lymph node metastasis in tour cases with the size of 1.0 - 1.2cm confirmed by pathology after operation. Conclusions PET/CT imaging is an important method for judging lymph node metastasis of ovarian malignant tumor before operation and has higher clinical gu

关 键 词：正电子发射计算机断层显像 卵巢肿瘤 转移 淋巴结 腹主动脉旁 腹膜后 盆腔 浅表 

分 类 号：R737.31[医药卫生—肿瘤]