^18F-FDG PET/CT在胸段食管鳞癌淋巴结转移中的诊断价值  

Value of ^18F-FDG PET/CT in detecting metastatic lymph nodes of thoracic esophageal squamous cell carcinoma

作　　者：李生栩[1] 唐明灯[1] 林端瑜[1] 刘道佳[1] 吕清湖 张杰平[1] 蔡志华[1] 

机构地区：[1]福建医科大学附属肿瘤医院核医学科,福州350014

出　　处：《国际放射医学核医学杂志》2016年第6期408-413,共6页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的 探讨18F-FDG PET/CT在胸段食管鳞癌淋巴结转移中的诊断价值，并与增强CT及术后病理结果进行对比。方法 胸段食管鳞癌患者54例，术前一周内行18F-FDG PET/CT和增强CT扫描，术后以病理学诊断为“金标准”，比较两种显像方法对胸段食管鳞癌淋巴结转移的灵敏度、特异度、准确率及不同短径范围的诊断准确率。应用SPSS13.0软件进行四格表χ^2检验。结果 手术共切取肿大淋巴结186枚，均经病理证实，其中淋巴结转移77枚，18F-FDG PET/CT诊断淋巴结转移的灵敏度、特异度及准确率分别为77.9%（60/77）、95.4%（104/109）和88.2%（164/186），增强CT分别为40.3%（31/77）、75.2%（82/109）和60.8%（113/186），二者诊断效能差异有统计学意义（χ^2=24.04、15.77和36.77，P均〈0.01）。对于短径〉5 mm（5-10 mm及≥10 mm）的淋巴结，18F-FDG PET/CT诊断的准确率高于增强CT，且差异有统计学意义（χ^2=26.03和26.47，P均〈0.01）；对于短径≤5 mm的淋巴结，二者间诊断的准确率差异无统计学意义（χ^2=0.24，P〉0.05）。结论 18F-FDG PET/CT在胸段食管鳞癌淋巴结转移中具有较高的诊断价值，对于短径〉5 mm的淋巴结优势明显。Objective To analyze the diagnostic value of 18F-FDG PET/CT and enhanced CT in detecting metastatic lymph nodes of thoracic esophageal squamous cell carcinoma. Methods Fifty-four patients with thoracic esophageal squamous cell carcinoma underwent both 18F-FDG PET/CT and enhanced CT before surgery within a week. All lesions were confirmed histopathologically as the golden standard. The sensitivity, specificity, and accuracy of the two imaging modalities were compared. In addition, the diagnostic accuracy of the two methods in detecting metastatic lymph nodes having different diameters in patients with thoracic esophageal squamous cell carcinoma was evaluated. Theχ^2-test was used with SPSS 13.0. Results A total of 186 lymph node specimens, including 77 specimens of metastases, were extracted and confirmed by pathology. The sensitivity, specificity, and accuracy of 18F-FDG PET/CT were 77.9%（60/77）, 95.4%（104/109）, 88.2%（164/186）, respectively, whereas those of enhanced CT were 40.3%（31/77）, 75.2%（82/109）, and 60.8%（113/186）, respectively. All values were statistically significant（χ^2=24.04, 15.77, and 36.77, all P〈0.01）. The diagnostic accuracy of 18F-FDG PET/CT is significantly better than that of enhanced CT in the group of R〉5 mm （χ^2=26.03 and 26.47, both P〈0.01） without the group of R≤5 mm（χ^2=0.24, P〉0.05）. Conclusion 18F-FDG PET/CT has a great value in detecting metastatic lymph nodes of thoracic esophageal squamous cell carcinoma, especially lymph nodes that are R〉5 mm.

关 键 词：食管肿瘤 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 淋巴结转移 短径 

分 类 号：R735.1[医药卫生—肿瘤] R730.44[医药卫生—临床医学]