18 F-FDG PET／CT对非小细胞肺癌淋巴结转移的诊断价值

摘要

Objective To assess the value of fuorine-18-fluom deoxy glucose positron emission tomography /computer tomography (18F-FDG PET/CT) in diagnosis of lymph node metastasis in the cases with non-small cell lung cancer ( NSCLC) .Methods From March 2012 to March 2015,167 patients underwent 18F-FDG PET/CT and contrast enhanced CT inspection within 10 days prior to the surgery and were pathologically diagnosed as non-small cell lung cancer(NSCLC) after surgery.With regard to estimation of the lymphatic metastasis,we com-pared the sensitivity,specificity,accuracy,positive and negative predictive value ,and Youden index between the PET/CT and contrast en-hanced CT.Results There were 731 lymph node stations from the 167 patients.Referred to the final pathological results ,PET/CT has screened 143 lymph node stations in true positive set ,26 lymph node stations in false positive set ,61 lymph node stations in false negative set , and 501 lymph node stations in true negative set .Furthermore,the sensitivity,specificity,the positive and negative forecast values ,and Youden index of PET/CT and CT was 70.10%vs.54.19%(P<0.05),95.07%vs.92.23%(P<0.05),88.10%vs.81.67%(P<0.05),84.62%vs.72.85%(P<0.05),89.15%vs.81.67%(P<0.05) and 0.65 vs.0.46 (P<0.05),respectively.Conclusion It is more effective to to precisely validate lymphatic metastasis of NSCLC by using PET /CT than using contrast enhanced CT inspection .Additionally,PET/CT can provide more information for the preoperative diagnosis , staging and the follow-up treatment of lung cancer .%目的：探讨18氟-脱氧葡萄糖正电子发射计算机断层显像／计算机体层成像（18F-FDG PET／CT）对非小细胞肺癌淋巴结转移的诊断价值。方法回顾性分析2012年3月至2015年3月我院167例患者的临床资料，所有病例术前10 d内行18F-FDG PET／CT及胸部增强CT检查并经术后病理诊断为非小细胞肺癌。根据PET／CT、增强CT及术后病理结果，计算PET／CT、增强CT判断淋巴结转移的灵敏度、特异性、准确度、阳性预测值、阴性预测值及约登指数并相互比较。结果167例患者中共清扫出731组淋巴结，以术后病理结果为依据，PET／CT诊断出真阳性、假阳性、假阴性、真阴性淋巴结各有143组、26组、61组、501组，进而得出其灵敏度、特异度、准确度、阳性预测值、阴性预测值、约登指数分别为70．10％、95．07％、88．10％、84．62％、89．15％、0．65，增强CT分别为54．19％、92．23％、81．67％、72．85％、83．97％、0．4，二者差异有统计学意义（ P＜0．05）。结论 PET／CT对非小细胞肺癌淋巴结转移的诊断效能高于增强CT，可以更好地为肺癌术前诊断、分期和后续治疗方式的选择提供依据。