^(18)F-脱氧葡萄糖正电子发射计算机断层显像/CT对T_(1~2)期非小细胞肺癌隐匿性淋巴结转移的诊断价值  

Diagnosis value of ^(18)F-fluorodeoxyglucose position emission tomography/CT in the occult lymph node metastasis in T_(1-2) stage non-small cell lung cancer

作　　者：刘佳[1] 黄颖[1] 廖恺 程刚[1] LIU Jia;HUANG Ying;LIAO Kai;CHENG Gang(Department of Nuclear Medicine,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400042,China)

机构地区：[1]重庆医科大学附属第一医院核医学科,重庆4000420

出　　处：《癌症进展》2022年第9期918-921,926,共5页Oncology Progress

摘　　要：目的探究^(18)F-脱氧葡萄糖(FDG)正电子发射计算机断层显像(PET)/CT代谢相关参数及临床资料在T_(1~2)期非小细胞肺癌(NSCLC)隐匿性淋巴结转移(OLM)中的预测价值。方法选取125例术前接受^(18)F-FDG PET/CT检查且行手术切除原发病灶和纵隔淋巴结清扫术的T_(1~2)期NSCLC患者。根据术后病理结果是否发生OLM分为OLM阴性组(n=94)和OLM阳性组(n=31),通过受试者工作特征(ROC)曲线评价各指标的诊断效能,采用单因素和多因素Logistic回归分析确定OLM的影响因素。结果OLM阴性组患者原发灶最大径小于OLM阳性组患者,差异有统计学意义(P﹤0.05)。OLM阴性组患者最大标准摄取值(SUV_(max))、平均标准摄取值(SUV_(mean))、肿瘤代谢体积(MTV)、病灶糖酵解总量(TLG)、肿瘤代谢异质因子(HF)值均低于OLM阳性组患者,差异均有统计学意义(P﹤0.05)。TLG有最高的曲线下面积(AUC)值,其预测T_(1~2)期NSCLC OLM的灵敏度为70.97%,特异度为79.79%。多因素分析结果显示,TLG﹥19.31是T_(1~2)期NSCLC OLM的危险因素(OR=4.429,95%CI:1.200~16.344,P﹤0.05)。结论对于T_(1~2)期NSCLC患者,TLG是OLM的独立预测因子,当肿瘤原发灶TLG﹥19.31时,应重点评估是否发生淋巴结转移,有助于临床医师选择合适的治疗方案。Objective To explore the predictive value of^(18)F-fluorodeoxyglucose(FDG)position emission tomography(PET)/CT metabolic parameters and clinical data in T_(1-2)stage non-small cell lung cancer(NSCLC)with occult lymph node metastasis(OLM).Method A total of 125 patients with stage T_(1-2)stage NSCLC who received preoperative^(18)F-FDG PET/CT examination and underwent surgical resection of primary lesion and mediastinal lymph node dissection were selected.According to postoperative pathological results,patients were divided into OLM negative group(n=94)and OLM positive group(n=31).The diagnostic efficiency of each index was evaluated through receiver operating characteristic(ROC)curve.Univariate and multivariate Logistic regression analysis was used to determine the influencing factors of OLM.Result The maximum diameter of primary lesion in OLM negative group was smaller than that in OLM positive group(P<0.05);the maximum standardized uptake value(SUV_(max)),mean standardized uptake value(SUV_(mean)),metabolic tumor volume(MTV),total lesion glycolysis(TLG)and heterogeneity factor(HF)values in OLM negative group were significantly lower than those in OLM positive group(P<0.05).TLG had the highest area under the curve(AUC)value,with the sensitivity and specificity of 70.97%and 79.79%,respectively in predicting T_(1-2)stage NSCLC OLM.Multivariate analysis showed that TLG>19.31 was the risk factor for T_(1-2)stage NSCLC OLM(OR=4.429,95%CI:1.200-16.344,P<0.05).Conclusion TLG is an independent predictor of OLM in patients with T_(1-2)stage NSCLC.Lymph node metastasis should be evaluated when TLG of primary tumor>19.31,which can help clinicians select appropriate treatment options.

关 键 词：非小细胞肺癌 淋巴结转移 正电子发射计算机断层显像 最大标准摄取值 

分 类 号：R734.2[医药卫生—肿瘤]