18 F-FDG PET-CT在非小细胞肺癌TNM分期中的应用及其临床意义

摘要

目的：比较18 F-FDG PET-CT显像、CT检测和金标准检测方法对非小细胞肺癌（NSCLC）TNM分期的诊断结果，探讨18 F-FDG PET-CT显像在 NSCLC TNM分期中的临床价值。方法：对65例确诊的行全身18 F-FDG PET-CT显像的 NSCLC患者通过盲法阅片进行TNM分期诊断；采用灵敏度（Se）、特异度（Sp）、阳性预测值（PPV）、阴性预测值（NPV）、符合率和Kappa分析评价PET-CT和 CT 2种诊断方法在 NSCLC患者 TNM分期中的诊断价值。结果：与金标准比较，CT和 PET-CT对65例 NSCLC患者 T分期诊断结果分别为符合率＝72.31％，Kappa＝0.46；符合率＝78.46％，Kappa＝0.60；对58例患者 N 分期诊断结果分别为符合率＝74.14％，Kappa＝0.50；符合率＝87.94％，Kappa＝0.78；CT和 PET-CT诊断淋巴结转移的结果分别为 Se＝64.04％，Sp＝77.53％，PPV＝85.07％，NPV＝51.88％，符合率＝68.54％，Kappa＝0.37；Se＝91.01％， Sp＝83.15％，PPV＝91.53％，NPV＝82.22％，符合率＝88.39％，Kappa＝0.74；PET-CT对 NSCLC远处转移的总体患者检出率和转移灶检出量均高于CT。结论：18 F-FDG PET-CT在诊断 NSCLC患者 TNM分期中具有较高的价值。%Objective To compare the diagnostic results of 18 F-deoxyglucose positron emission tomographic-computed tomographic (18 F-FDG PET-CT)imaging ,CT and golden standards in TNM stating of non-small cell lung cancer (NSCLC), and to evaluate the diagnostic value of 18 F-FDG PET-CT imaging in TNM staging of NSCLC.Methods 18 F-FDG PET-CT was performed in the 65 patients with NSCLC who were diagnosed by pathology.Blind interpretation was used to dignose the TNM staging.The sensitivity(Se),specificity(Sp), positive predict value(PPV)and negative predict value(NPV),coincidence rate and Kappa analysis were performed to evaluate the values of PET-CT and CT in diagnosing TNM staging of NSCLC.Results Compared with golden standard,the diagnostic results of T staging among 65 NSCLC patients by CT and PET-CT were respectively as coincidence rate=72.31%,Kappa=0.46;coincidence rate=78.46%,Kappa=0.60;the diagnostic results of N staging among 58 NSCLC patients by CT and PET-CT were respectively as coincidence rate=74.14%,Kappa=0.50;coincidence rate = 87.94%,Kappa=0.78;the diagnostic results of lymph node metastasis by CT and PET-CT were respectively as Se=64.04%,Sp=77.53%,PPV=85.07%,NPV=51.88%,coincidence rate =68.54%,Kappa=0.37;Se=91.01%,Sp=83.15%,PPV=91.53%,NPV=82.22%,coincidence rate =88.39%,Kappa=0.74;the total detection rate and amount of metastasis by PET-CT were significantly higher than that by CT. Conclusion 18 F-FDG PET-CT has significant value on the diagnosis of the TNM staging of NSCLC.