^(18)F-FDG PET/CT诊断肾细胞癌腹膜后淋巴结转移  

^(18)F-FDG PET/CT diagnosis of retropertoneal lymph node metastases in renal cell carcinoma

作　　者：祝安惠[1] 张帆[2] 张卫方[1] ZHU Anhui;ZHANG Fan;ZHANG Weifang(Department of Nuclear Medicine,Peking University Third Hospital,Beijing 100191,China;Department of Urology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院核医学科,北京100191 [2]北京大学第三医院泌尿外科,北京100191

出　　处：《中国医学影像技术》2024年第12期1884-1888,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的评估^(18)F-FDG PET/CT诊断肾细胞癌(RCC)腹膜后淋巴结转移的价值。方法纳入50例RCC患者,根据术后病理显示有无淋巴结转移将其分为转移组(n=16)与未转移组(n=34);比较组间PET/CT表现,与病理所见对照,分析PET/CT在个体及区域淋巴结组水平诊断腹膜后淋巴结转移的效能。结果转移组原发灶最大径、淋巴结短径及其最大标准摄取值均大于未转移组(P均<0.05)。PET/CT正确诊断转移组15例、未转移组28例。术中共切除59个腹膜后区域淋巴结组,病理共诊断19个区域淋巴结转移,PET/CT正确诊断其中18个;40个区域淋巴结组病理未见转移,PET/CT诊断正确其中33个。PET/CT诊断个体水平腹膜后淋巴结转移的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为93.75%、82.35%、86.00%、71.43%和96.55%;诊断区域淋巴结水平转移分别为97.74%、82.50%、86.44%、72.00%和97.06%。淋巴结短径是RCC腹膜后淋巴结转移的独立影响因素(OR=487.100,P=0.002);以1.25 cm为截断值,其诊断RCC淋巴结转移的敏感度为93.80%,特异度为85.30%,曲线下面积为0.951。结论^(18)F-FDG PET/CT诊断RCC腹膜后淋巴结转移具有较高敏感度和阴性预测值。Objective To evaluate the efficacy of^(18)F-FDG PET/CT for diagnosing retropertoneal lymph node metastases in renal cell carcinoma(RCC).Methods Totally 50 RCC patients were enrolled and divided into metastases group(n=16)and non-metastasis group(n=34)according to postoperative pathology showed lymph node metastases or not.PET/CT imaging features were compared between groups,and the diagnostic efficacy of PET/CT at case level and lymph node region level were analyzed compared with pathological findings.Results The maximum diameter of the primary tumor,the short diameter and the maximal standard uptake value of lymph node in metastases group were all larger than those in non-metastasis group(all P<0.05).PET/CT correctly diagnosed 15 cases in metastases group and 28 cases in non-metastasis group.Among 59 resected retroperitoneal lymph node regions in 50 cases,PET/CT correctly diagnosed metastases in 18 regions.Among other 40 lymph node regions pathology found no metastasis,PET/CT correctly diagnosed 33 regions.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of PET/CT for diagnosing retroperitoneal lymph node metastasis at case level was 93.75%,82.35%,86.0%,71.43%,and 96.55%,respectively,while at lymph node region level was 97.74%,82.50%,86.44%,72.00%and 97.06%,respectively.The short diameter of lymph node was an independent impact factor for diagnosing lymph node metastasis of RCC(OR=487.100,P=0.002).Taken 1.25 cm as the cut-off value,the sensitivity,specificity and the area under the curve of the short diameter of lymph node for diagnosing RCC lymph node metastasis was 93.80%,85.30%and 0.951,respectively.Conclusion^(18)F-FDG PET/CT had high sensitivity and negative predictive value for diagnosing RCC retroperitoneal lymph node metastasis.

关 键 词：肾肿瘤 肿瘤转移 正电子发射断层显像和计算机体层摄影术 

分 类 号：R737.11[医药卫生—肿瘤] R817.4[医药卫生—临床医学]