螺旋CT和PET-CT扫描诊断肺癌及淋巴结转移的临床价值  

Clinical Value of Spiral CT and PET-CT in the Diagnosis of Lung Cancer and Lymph Node Metastasis

作　　者：王家富[1] 林琳[1] 林耀云[1] 王杨[1] 王洋洋[1] 李勇[1] WANG Jiafu;LIN Lin;LIN Yaoyun(The First Affiliated Hospital of Harbin Medical University,Heilongjiang Haerbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院核医学科,黑龙江哈尔滨150001

出　　处：《河北医学》2021年第2期283-287,共5页Hebei Medicine

基　　金：黑龙江省卫生计生委科研课题项目,(编号:2018-4-04)。

摘　　要：目的:探讨螺旋CT、PET-CT扫描诊断肺癌及淋巴结转移的临床价值。方法:选取2018年1月至2019年8月我院收治的确诊为肺癌且疑似淋巴结转移患者96例,于就诊2周内,均行螺旋CT及PET-CT诊断,并基于最后手术病理结果,比较2种诊断方式诊断肺癌及淋巴结转移的效能。结果:手术病理学结果显示,96例可疑性肺癌淋巴结转移患者中,22例无淋巴结转移,74例发生淋巴结转移,其中,32例出现局部复发病灶;共检出转移淋巴结102枚,其中,直径≤0.5cm转移淋巴结有6枚,0.5~1.0cm转移淋巴结有75枚,直径≥1.0cm转移淋巴结有21枚。螺旋CT、PET-CT诊断肺癌淋巴结各自准确度、灵敏度、特异度、阳性预测率、阴性预测率分别为75.0%、74.3%、77.3%、91.7%、47.2%;94.8%、97.4%、86.4%、96.0%、90.5%。在转移淋巴结检出方面,PET-CT总检出率明显高于螺旋CT(P<0.05)。其中,在≤0.5cm、0.5~1.0cm转移淋巴结转移上,PET-CT检出率明显高于螺旋CT,差异具有统计学意义(P<0.05);在≥1.0cm转移淋巴结上,两者无显著差异,不具有统计学意义(P>0.05)。结论:相较于螺旋CT诊断方式,PET-CT诊断肺癌及淋巴结转移诊断效能更为显著,具有临床应用价值,但费用较高,广谱性较弱,因此,可在螺旋CT难以确定时,作为进一步诊断手段,提高诊断准确度。Objective:To explore the clinical value of spiral CT and PET-CT scan in the diagnosis of lung cancer and lymph node metastasis.Methods:96 patients with lung cancer and suspected lymph node metastasis admitted to our hospital from January 2018 to August 2019 were selected.Within 2 weeks,spiral CT and PET-CT were performed.Based on the final surgical and pathological results,the efficacy of the two diagnostic methods in the diagnosis of lung cancer and lymph node metastasis was compared.Results:The results of surgical pathology showed that among 96 patients with suspected lung cancer lymph node metastasis,22 had no lymph node metastasis and 74 had lymph node metastasis.Among them,32 had local recurrence lesions;a total of 102 metastatic lymph nodes were detected,of which diameter There are 6 metastatic lymph nodes of≤0.5cm,75 metastatic lymph nodes of 0.5~1.0cm,and 21 metastatic lymph nodes of diameter≥1.0cm.The accuracy,sensitivity,specificity,positive prediction rate,and negative prediction rate of spiral CT and PET-CT in the diagnosis of lung cancer lymph nodes were 75.0%,74.3%,77.3%,91.7%,47.2%;94.8%,97.4%,86.4%,96.0%,90.5%.In the detection of metastatic lymph nodes,the total detection rate of PET-CT was significantly higher than that of spiral CT(P<0.05).In the detection of metastatic lymph nodes,the total detection rate of PET-CT was significantly higher than that of spiral CT(P<0.05).Among them,the detection rate of PET-CT was significantly higher than that of spiral CT on≤0.5cm and 0.5-1.0cm metastatic lymph node metastasis,and the difference was statistically significant(P<0.05);on≥1.0cm metastatic lymph node,neither Significant difference,not statistically significant(P>0.05).Conclusion:Compared with spiral CT diagnosis,PET-CT diagnosis of lung cancer and lymph node metastasis diagnostic efficiency is more significant,with clinical application value,but the cost is higher,broad-spectrum is weak,so it can be used as a further diagnostic means to improve the diagnostic accuracy when spiral CT is dif

关 键 词：螺旋CT PET-CT 肺癌 淋巴结转移 诊断效能 

分 类 号：R734.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]