^18F-FDG PET-CT在淋巴瘤诊断、分期及治疗决策中的价值  

Value of ^18F-FDG PET-CT in the diagnosis, staging and treatment decision of lymphoma

作　　者：张玲芳[1] 刘乐[1] 邰宵辉 张旭霞[1] 杨静[1] 王晓焕 李红玲[1] Zhang Lingfang;Liu Le;Tai Xiaohui;Zhang Xuxia;Yang Jing;Wang Xiaohuan;Li Hongling(Department of Medicine Oncology,Gansu Provincial Hospital,Lanzhou 730000,China)

机构地区：[1]甘肃省人民医院肿瘤内科,兰州730000

出　　处：《白血病．淋巴瘤》2019年第6期340-344,共5页Journal of Leukemia & Lymphoma

基　　金：甘肃省自然科学基金(17JR5RA037);甘肃省人民医院院内科研基金(16GSSY2-7).

摘　　要：目的明确^18F-FDG PET-CT在淋巴瘤诊断、分期以及指导治疗中的临床应用价值.方法收集2011年1月至2016年12月在甘肃省人民医院经病理确诊为淋巴瘤并同期行^18F-FDG PET-CT以及增强CT检查的患者136例,比较两种检查方法的灵敏度、特异度、准确率、阳性预测值、阴性预测值,并分析^18F-FDG PET-CT对淋巴瘤诊断、临床分期以及治疗方案选择的影响.结果^18F-FDG PET-CT诊断淋巴瘤的灵敏度、特异度、准确率、阳性预测值、阴性预测值分别为98.2%、82.1%、94.9%、95.5%、92.0%,增强CT分别为80.6%、67.9%、77.9%、90.6%、47.5%;二者诊断的灵敏度及特异度比较,差异有统计学意义(χ^2=16.0,P<0.01);^18F-FDG PET-CT的准确率高于增强CT.与增强CT相比,^18F-FDG PET-CT检查后20.6%(26/136)患者的临床分期上调,2.9%(4/136)下调.分期调整后11.8%(16/136)的患者改变了治疗方案.结论^18F-FDG PET-CT在淋巴瘤的诊断、分期以及指导治疗方面的价值高于增强CT,在淋巴瘤的诊疗中有广阔的应用前景.Objective To investigate the clinical value of ^18F-FDG PET-CT in the diagnosis, clinical staging and treatment guide of malignant lymphoma. Methods A total of 136 lymphoma patients confirmed by pathological diagnosis who received ^18F-FDG PET-CT and contrast enhanced CT (CECT) examination in Gansu Provincial Hospital from January 2011 to December 2016 were collected. The sensitivity, specificity, accuracy, positive predictive values (PPV) and negative predictive values (NPV) of ^18F-FDG PET-CT and CECT were evaluated, respectively. The effects of ^18F-FDG PET-CT on diagnosis, clinical staging and treatment regimens of lymphoma were analyzed. Results The sensitivity, specificity, accuracy, PPV and NPV of ^18F-FDG PET-CT in the diagnosis of lymphoma for all 136 patients was 98.2%, 82.1%, 94.9%, 95.5% and 92.0%, respectively. CECT was 80.6%, 67.9%, 77.9%, 90.6% and 47.5%, respectively. The difference in sensitivity and specificity between ^18F-FDG PET-CT and CECT was statistically significant (χ^2= 16.0, P<0.01). The accuracy of ^18F-FDG PET-CT was higher than that of CECT. Compared with CECT, 26 (20.6%) patients with image of ^18F-FDG PET-CT showed the increase of the clinical staging, 4 (2.9%) patients showed the decrease of the clinical staging, and 16 (11.8%) patients changed the treatment regimen after the stage alteration. Conclusion ^18F-FDG PET-CT is superior to CECT in the diagnosis, clinical staging and treatment guide of lymphoma, which shows the promising prospect in the diagnosis and treatment of lymphoma.

关 键 词：淋巴瘤 氟脱氧葡萄糖F^18 正电子发射断层显像术 增强计算机体层摄影术 

分 类 号：R730.44[医药卫生—肿瘤]