18F-FDG PET/CT多种参数定量分析在鉴别非小细胞肺癌纵隔淋巴结转移中的应用研究  

The application value of quantitative analysis of differential diagnosis of mediastinal lymph node metastasis in patients with non-small cell lung cancer by using 18F-FDG PET/CT

作　　者：李晓东[1] 郑晓萌[2] 范如意[1] 董曦曹 曹艳霞[1] LI Xiaodong;ZHENG Xiaomeng;FAN Ruyi(Department of Nuclear Medicine,Affiliated Hospital of Hebei University,Hebei,Baoding 071000,China)

机构地区：[1]河北大学附属医院核医学科,河北省保定市071000 [2]河北大学附属医院检验科,河北省保定市071000

出　　处：《河北医药》2020年第7期1036-1039,共4页Hebei Medical Journal

摘　　要：目的研究18F-FDG PET/CT多种参数定量分析在鉴别非小细胞肺癌纵隔淋巴结转移中的应用价值。方法回顾性分析2016年8月至2018年8月35例非小细胞肺癌患者资料,男22例,女13例;平均年龄(61.21±8.01)岁,术前均行18F-FDG PET/CT显像。以CT值、maximal standardized uptake values(SUVmax)、SUVmax/CT值、短径、长短径比值五项指标对经手术证实的转移性淋巴结33枚及非转移性淋巴结68枚进行分析,比较2组淋巴结的上述指标有无差异。利用ROC曲线确定各指标鉴别界值并评价各指标诊断效能。利用χ^2检验比较各指标的灵敏度、特异度和准确度。结果与非转移性淋巴结比较,转移性淋巴结具有CT值变小、SUVmax增大、SUVmax/CT值增加、短径增大、长短径比值变小等特点;且均有显著性差异(P<0.05)。当上述五项指标的界值分别取41、2.3、0.044、0.95和1.5时,其准确度分别为68.32%、84.16%、96.04%、80.20%和45.54%;SUVmax/CT值诊断准确率最高(χ^2=7.35,P<0.005),长短径比值诊断准确率最低(χ^2=10.74,P<0.005);ROC曲线下面积分别为81.4%、89.3%、96.7%、80.9%和57.8%。结论PET/CT多种参数定量分析对于鉴别诊断纵隔淋巴结转移具有重要意义,其中SUVmax/CT值诊断效能最高。Objective To investigate the application value of quantitative analysis of differential diagnosis of mediastinal lymph node metastasis in patients with non-small cell lung cancer(NSCLC)by using 18F-FDG PET/CT.Methods The clinical data about 35 patients with NSCLC[22 males and 13 females,with mean age being(61.21±8.01)yr]who underwent 18F-FDG PET/CT examination before surgery in our hospital from August 2016 to August 2018 were retrospectively analyzed.The clinical data of 33 cases of malignant lymph node and 68 cases benign lymph node were analyzed according to the CT value,SUVmax,SUVmax/CT value,short diameter and ratio of length to diameter.Moreover ROC curve was used to evaluate the diagnostic efficiency and to determine the distinguishing boundary value of these indexes.In addition the sensitivity,specificity and diagnostic accuracy of each index were analyzed by mmeans ofχ^2 test.Results As compared with non-metastatic lymph nodes,metastatic lymph nodes had the characteristics of smaller CT value,higher SUVmax,higher SUVmax/CT value,longer diameter and smaller ratio of long to short diameter(P<0.01 or P<0.05).When the boundary values of the five indexes were 41,2.3,0.044,0.95 and 1.5,respectively,the accuracy was 68.32%,84.16%,96.04%,80.20%and 45.54%,respectively.The accuracy of SUVmax/CT was the highest(χ^2=7.35,P<0.05),and the accuracy of the ratio of length to diameter was the lowest(χ^2=10.74,P<0.05).The area under ROC curve was 81.4%,89.3%,96.7%,80.9%and 57.8%,respectively.Conclusion The quantitative analysis of PET/CT is quite significant in diagnosis of mediastinal lymph node metastasis in patients with NSCLC,and SUVmax/CT value has the highest diagnostic efficiency.

关 键 词：非小细胞肺癌 定量分析 正电子发射断层显像术 体层摄影术 脱氧葡萄糖 

分 类 号：R734.2[医药卫生—肿瘤]