18F-FDG PET/CT对非小细胞肺癌淋巴结转移的诊断价值  

Value of 18F-FDG PET/CT for diagnosis of lymphatic metastasis in patients with non-small cell lung cancer

作　　者：张礼平[1] 邓波[1] 王如文[1] 周景海[1] 郭伟[1] 牛会军[1] 马铮[1] 康珀铭[1] 陶绍霖[1] 谭群友[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所胸外科,重庆400042

出　　处：《局解手术学杂志》2016年第3期184-187,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨18氟-脱氧葡萄糖正电子发射计算机断层显像/计算机体层成像(18F-FDG PET/CT)对非小细胞肺癌淋巴结转移的诊断价值。方法回顾性分析2012年3月至2015年3月我院167例患者的临床资料,所有病例术前10 d内行18FFDG PET/CT及胸部增强CT检查并经术后病理诊断为非小细胞肺癌。根据PET/CT、增强CT及术后病理结果,计算PET/CT、增强CT判断淋巴结转移的灵敏度、特异性、准确度、阳性预测值、阴性预测值及约登指数并相互比较。结果 167例患者中共清扫出731组淋巴结,以术后病理结果为依据,PET/CT诊断出真阳性、假阳性、假阴性、真阴性淋巴结各有143组、26组、61组、501组,进而得出其灵敏度、特异度、准确度、阳性预测值、阴性预测值、约登指数分别为70.10%、95.07%、88.10%、84.62%、89.15%、0.65,增强CT分别为54.19%、92.23%、81.67%、72.85%、83.97%、0.4,二者差异有统计学意义(P<0.05)。结论 PET/CT对非小细胞肺癌淋巴结转移的诊断效能高于增强CT,可以更好地为肺癌术前诊断、分期和后续治疗方式的选择提供依据。Objective To assess the value of fuorine-18-fluom deoxy glucose positron emission tomography/computer tomography（ 18 FFDG PET/CT） in diagnosis of lymph node metastasis in the cases with non-small cell lung cancer（ NSCLC）. Methods From March 2012 to March 2015,167 patients underwent 18F-FDG PET/CT and contrast enhanced CT inspection within 10 days prior to the surgery and were pathologically diagnosed as non-small cell lung cancer（ NSCLC） after surgery. With regard to estimation of the lymphatic metastasis,we compared the sensitivity,specificity,accuracy,positive and negative predictive value,and Youden index between the PET/CT and contrast enhanced CT. Results There were 731 lymph node stations from the 167 patients. Referred to the final pathological results,PET/CT has screened 143 lymph node stations in true positive set,26 lymph node stations in false positive set,61 lymph node stations in false negative set,and 501 lymph node stations in true negative set. Furthermore,the sensitivity,specificity,the positive and negative forecast values,and Youden index of PET/CT and CT was 70. 10% vs. 54. 19%（ P〈0. 05）,95. 07% vs. 92. 23%（ P〈0. 05）,88. 10% vs. 81. 67%（ P〈0. 05）,84. 62%vs. 72. 85%（ P〈0. 05）,89. 15% vs. 81. 67%（ P〈0. 05） and 0. 65 vs. 0. 46（ P〈0. 05）,respectively. Conclusion It is more effective to to precisely validate lymphatic metastasis of NSCLC by using PET/CT than using contrast enhanced CT inspection. Additionally,PET/CT can provide more information for the preoperative diagnosis,staging and the follow-up treatment of lung cancer.

关 键 词：18氟-脱氧葡萄糖正电子发射计算机断层显像/计算机体层成像 非小细胞肺癌 淋巴结转移 诊断 

分 类 号：R445.6[医药卫生—影像医学与核医学] R734.2[医药卫生—诊断学]