^(99)Tc^(m)-异腈氨基葡萄糖SPECT/CT诊断非小细胞肺癌区域淋巴结转移的价值  

Diagnostic Value of^(99)Tc^(m)-Isonitrile Deoxy Glucosamine SPECT/CT for Regional Lymph Node Metastasis in Non-Small Cell Lung Cancer

作　　者：王勤奋[1] 秦将均[2] 许有忠 卢传刚 李志伟[2] 王平[1] 吴一清 陈丽娥 WANG Qinfen;QIN Jiangjun;XU Youzhong;LU Chuangang;LI Zhiwei;WANG Ping;WU Yiqing;CHEN Lie(Department of Nuclear Medicine,Sanya Central Hospital(the Third People's Hospital of Hainan Province),Sanya 572022,China)

机构地区：[1]三亚中心医院(海南省第三人民医院)核医学科,海南三亚572022 [2]三亚中心医院(海南省第三人民医院)放射科,海南三亚572022 [3]三亚中心医院(海南省第三人民医院)心胸外科,海南三亚572022 [4]三亚中心医院(海南省第三人民医院)病理科,海南三亚572022

出　　处：《中国医学影像学杂志》2023年第6期606-610,共5页Chinese Journal of Medical Imaging

基　　金：海南省三亚市医疗卫生科技创新项目(2019YW05)。

摘　　要：目的探讨^(99)Tc^(m)-异腈氨基葡萄糖(CN5DG)SPECT/CT对非小细胞肺癌(NSCLC)区域淋巴结转移的诊断价值。资料与方法前瞻性纳入2019年10月—2021年8月三亚中心医院确诊的21例NSCLC,在根治性外科手术前接受^(99)Tc^(m)CN5DG SPECT/CT和强化CT,以术后病理结果为“金标准”,比较^(99)Tc^(m)-CN5DG SPECT/CT和强化CT诊断NSCLC区域淋巴结转移的价值。结果^(99)T^(cm)-CN5DG SPECT/CT诊断NSCLC区域淋巴结转移的敏感度、特异度、准确度、阳性预测值、阴性预测值均高于强化CT(84.6%、93.2%、92.1%、64.7%、97.6%比46.2%、84.1%、79.2%、30.0%、91.4%),其中特异度、准确度差异有统计学意义(χ^(2)=6.40、9.94,P均<0.05)。^(99)Tc^(m)-CN5DG SPECT/CT诊断NSCLC患者N分期的准确度高于强化CT(81.0%比52.4%),差异有统计学意义(P=0.031)。结论^(99)Tc^(m)-CN5DG SPECT/CT对NSCLC区域淋巴结转移的诊断效能高于强化CT,可以更好地为NSCLC术前分期、治疗决策提供依据。Purpose To investigate the value of^(99)Tc^(m)-isonitrile deoxy glucosamine single photon emission computed tomography/computed tomography(^(99)Tc^(m)-CN5DG SPECT/CT)in the diagnosis of regional lymph node metastasis in non-small cell lung cancer(NSCLC).Materials and Methods A total of 21 NSCLC patients diagnosed in Sanya Central Hospital from October 2019 to August 2021were prospectively enrolled,patients underwent^(99)Tc^(m)-CN5DG SPECT/CT and enhanced CT before curative surgical resection.The postoperative pathological results served as the golden standard,the value of^(99)Tc^(m)-CN5DG SPECT/CT and enhanced CT in the diagnosis of regional lymph nodes in NSCLC was compared.Results The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of^(99)Tc^(m)-CN5DG SPECT/CT in the diagnosis of regional lymph node metastasis were significantly higher than those of enhanced CT(84.6%,93.2%,92.1%,64.7%and 97.6%vs.46.2%,84.1%,79.2%,30.0%and 91.4%,respectively),there were significant differences in specificity and accuracy between the two groups(χ^(2)=6.40,9.94,both P<0.05).The accuracy of^(99)Tc^(m)-CN5DG SPECT/CT in diagnosing N-stage of NSCLC patients was significantly higher than that of enhanced CT(81.0%vs.52.4%),and the difference was statistically significant(P=0.031).Conclusion It is more effective to precisely validate regional lymph node metastasis of NSCLC by using^(99)Tc^(m)-CN5DG SPECT/CT than using enhanced CT,thus^(99)Tc^(m)-CN5DG SPECT/CT can provide a better basis for preoperative staging and treatment decisionmaking of NSCLC.

关 键 词：癌 非小细胞肺 淋巴结转移 体层摄影术 发射型计算机 单光子 脱氧氨基葡萄糖 诊断 鉴别 

分 类 号：R734.2[医药卫生—肿瘤] R445[医药卫生—临床医学]