PET-CT显像在肺癌诊断中的临床价值分析  

Analysis of clinical value of PET-CT imaging in the diagnosis of lung cancer

作　　者：刘先伟[1] LIU Xian-wei(Department of Respiratory and Critical Care Medicine,Gaoxian County People's Hospital,Yibin 645154,China)

机构地区：[1]高县人民医院呼吸与危重症医学科,645154

出　　处：《中国实用医药》2023年第7期74-77,共4页China Practical Medicine

摘　　要：目的探析正电子发射计算机断层显像(PET)-CT显像在肺癌(LCA)治疗中的临床应用价值。方法100例LCA患者,分别开展PET-CT、螺旋CT检测,以手术病理结果为金标准,分析诊断效能。结果手术病理显示,100例LCA患者中,未见淋巴结转移23例,可见淋巴结转移77例,其中局部复发病灶33例,77例LAC伴淋巴结转移者检出106枚转移淋巴结,其中6枚转移淋巴结直径<0.5 cm,78枚转移淋巴结直径在0.5~1.0 cm,22枚转移淋巴结直径>1.0 cm。PET-CT诊断LCA阳性98例,阴性2例,诊断准确度为98%;螺旋CT诊断LCA阳性99例,阴性1例,诊断准确度为99%。PET-CT、螺旋CT诊断LCA准确度比较,差异无统计学意义(P<0.05)。PET-CT诊断:淋巴结转移78例,淋巴结未转移22例;阳性预测值、阴性预测值、灵敏度、特异度、准确度分别为96.2%(75/78)、90.9%(20/22)、97.4%(75/77)、87.0%(20/23)、95.0%(95/100)。螺旋CT诊断:淋巴结转移62例,淋巴结未转移38例;阳性预测值、阴性预测值、灵敏度、特异度、准确度分别为91.9%(57/62)、47.4%(18/38)、74.0%(57/77)、78.3%(18/23)、75.0%(75/100)。PET-CT诊断淋巴结是否转移的阴性预测值、灵敏度与准确度高于螺旋CT诊断,差异有统计学意义(P<0.05)。PET-CT对转移淋巴结总检出率94.34%高于螺旋CT的76.42%,差异有统计学意义(P<0.05)。PET-CT对直径<0.5 cm、0.5~1.0 cm的转移淋巴结检出率高于螺旋CT,差异有统计学意义(P<0.05)。PET-CT与螺旋CT对直径>1.0 cm转移淋巴结检出率比较,差异无统计学意义(P>0.05)。结论与螺旋CT相比,LCA、淋巴结转移诊断时选择PET-CT应用价值显著,可提高诊断准确度。Objective To discuss the clinical value of positron emission tomography(PET)-CT in the treatment of lung cancer(LCA).Methods 100 cases of LCA patients were examined by PET-CT and spiral CT,respectively.The pathological results of surgery were used as the gold standard to analyze the diagnostic efficacy.Results Surgical pathology showed that among the 100 patients with LCA,23 cases had no lymph node metastasis,77 cases had lymph node metastasis,among which 33 cases had local recurrence.After detection of 77 cases of LAC with lymph node metastasis,106 metastatic lymph nodes were detected,of which 6 nodes were<0.5 cm in diameter,78 nodes were 0.5-1.0 cm in diameter and 22 nodes were>1.0 cm in diameter.PETCT diagnosed 98 cases of positive LCA and 2 cases of negative LCA,with a diagnostic accuracy of 98%;spiral CT diagnosed 99 cases of positive LCA and 1 case of negative LCA,with a diagnostic accuracy of 99%.There was no statistically significant difference in the accuracy of PET-CT and spiral CT in diagnosing LCA(P<0.05).PET-CT diagnosis:78 cases with lymph node metastasis,22 cases without lymph node metastasis;the positive predictive value,negative predictive value,sensitivity,specificity and accuracy were 96.2%(75/78),90.9%(20/22),97.4%(75/77),87.0%(20/23)and 95.0%(95/100),respectively.Spiral CT diagnosis:62 cases with lymph node metastasis,38 cases without lymph node metastasis;the positive predictive value,negative predictive value,sensitivity,specificity and accuracy were 91.9%(57/62),47.4%(18/38),74.0%(57/77),78.3%(18/23)and 75.0%(75/100),respectively.The negative predictive value,sensitivity and accuracy of PET-CT for diagnosis of lymph node metastasis were higher than spiral CT,and the difference was statistically significant(P<0.05).The total detection rate of PET-CT for metastatic lymph nodes was 94.34%,which was higher than that of 76.42%of spiral CT,and the difference was statistically significant(P<0.05).The detection rates of metastatic lymph nodes<0.5 cm and 0.5-1.0 cm in diameter by PET-CT were higher

关 键 词：淋巴结转移 手术病理 正电子发射计算机断层显像-CT 螺旋CT 诊断效能 灵敏度 

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