中国CT和MRI杂志
中國CT和MRI雜誌
중국CT화MRI잡지
CHINESE JOURNAL OF CT AND MRI
2014年
3期
70-74
,共5页
非小细胞肺癌%淋巴结转移%氟代脱氧葡萄糖%正电子发射断层与计算机断层成像%计算机体层摄影术
非小細胞肺癌%淋巴結轉移%氟代脫氧葡萄糖%正電子髮射斷層與計算機斷層成像%計算機體層攝影術
비소세포폐암%림파결전이%불대탈양포도당%정전자발사단층여계산궤단층성상%계산궤체층섭영술
Non-small Cell Lung Cancer%Metastatic Lymph Node%Fludeoxyglucose%Positron Emission Tomography and Computed Tomography Imaging%Computed Tomography%Standardized Uptake Value
目的：探讨18F-FDG PET-CT显像对非小细胞肺癌术前区域淋巴结诊断及分期的临床应用价值。方法回顾分析64例非小细胞肺癌患者术前PET-CT及CT对肺门、纵隔淋巴结的诊断及分期结果，并与术后病理诊断结果进行对照。结果64例患者共清扫淋巴结280组(828枚)，其中34组(39枚)病理证实为转移。PET-CT术前正确诊断阳性淋巴结25组，阴性淋巴结237组；CT术前正确诊断阳性淋巴结9组，阴性淋巴结243组。PET-CT与CT诊断纵隔淋巴结转移的灵敏度、特异性、准确性、阳性及阴性预测值分别为73.5%(25/34)、96.3%(237/246)、93.6%(262/280)、73.5%(25/34)、96.3%(237/246)与26.5%(9/34)、98.7%(243/246)、90.0%(252/280)、75.0%(9/12)、91.0%(243/267)。其中两种检查方法的灵敏度和阴性预测值之间差异有统计学意义(P＜0.05)。PET-CT与CT对区域淋巴结N0、N1、N2分期的准确率分别为88.4%(38/43)、20%(2/10)、81.8%(9/12)与93.0%(40/43)、20%(2/10)、45.4%(5/11)。PET-CT较CT对N2分期的正确率与CT比较虽呈明显增高态势，但无统计学意义(P＞0.05)。比较PET-CT对N0、N1、N2分期正确率，N0＞N1，N2＞N1，两两相比有明显差异(P＜0.05)，但N0和N2分期正确率相比则无统计学意义(P＞0.05)。结论 PET-CT较CT对NSCLC术前区域淋巴结转移诊断和分期具有明显的优势，但存在一定的假阳性和假阴性，诊断时需要结合临床及其它检查结果综合判断。
目的：探討18F-FDG PET-CT顯像對非小細胞肺癌術前區域淋巴結診斷及分期的臨床應用價值。方法迴顧分析64例非小細胞肺癌患者術前PET-CT及CT對肺門、縱隔淋巴結的診斷及分期結果，併與術後病理診斷結果進行對照。結果64例患者共清掃淋巴結280組(828枚)，其中34組(39枚)病理證實為轉移。PET-CT術前正確診斷暘性淋巴結25組，陰性淋巴結237組；CT術前正確診斷暘性淋巴結9組，陰性淋巴結243組。PET-CT與CT診斷縱隔淋巴結轉移的靈敏度、特異性、準確性、暘性及陰性預測值分彆為73.5%(25/34)、96.3%(237/246)、93.6%(262/280)、73.5%(25/34)、96.3%(237/246)與26.5%(9/34)、98.7%(243/246)、90.0%(252/280)、75.0%(9/12)、91.0%(243/267)。其中兩種檢查方法的靈敏度和陰性預測值之間差異有統計學意義(P＜0.05)。PET-CT與CT對區域淋巴結N0、N1、N2分期的準確率分彆為88.4%(38/43)、20%(2/10)、81.8%(9/12)與93.0%(40/43)、20%(2/10)、45.4%(5/11)。PET-CT較CT對N2分期的正確率與CT比較雖呈明顯增高態勢，但無統計學意義(P＞0.05)。比較PET-CT對N0、N1、N2分期正確率，N0＞N1，N2＞N1，兩兩相比有明顯差異(P＜0.05)，但N0和N2分期正確率相比則無統計學意義(P＞0.05)。結論 PET-CT較CT對NSCLC術前區域淋巴結轉移診斷和分期具有明顯的優勢，但存在一定的假暘性和假陰性，診斷時需要結閤臨床及其它檢查結果綜閤判斷。
목적：탐토18F-FDG PET-CT현상대비소세포폐암술전구역림파결진단급분기적림상응용개치。방법회고분석64례비소세포폐암환자술전PET-CT급CT대폐문、종격림파결적진단급분기결과，병여술후병리진단결과진행대조。결과64례환자공청소림파결280조(828매)，기중34조(39매)병리증실위전이。PET-CT술전정학진단양성림파결25조，음성림파결237조；CT술전정학진단양성림파결9조，음성림파결243조。PET-CT여CT진단종격림파결전이적령민도、특이성、준학성、양성급음성예측치분별위73.5%(25/34)、96.3%(237/246)、93.6%(262/280)、73.5%(25/34)、96.3%(237/246)여26.5%(9/34)、98.7%(243/246)、90.0%(252/280)、75.0%(9/12)、91.0%(243/267)。기중량충검사방법적령민도화음성예측치지간차이유통계학의의(P＜0.05)。PET-CT여CT대구역림파결N0、N1、N2분기적준학솔분별위88.4%(38/43)、20%(2/10)、81.8%(9/12)여93.0%(40/43)、20%(2/10)、45.4%(5/11)。PET-CT교CT대N2분기적정학솔여CT비교수정명현증고태세，단무통계학의의(P＞0.05)。비교PET-CT대N0、N1、N2분기정학솔，N0＞N1，N2＞N1，량량상비유명현차이(P＜0.05)，단N0화N2분기정학솔상비칙무통계학의의(P＞0.05)。결론 PET-CT교CT대NSCLC술전구역림파결전이진단화분기구유명현적우세，단존재일정적가양성화가음성，진단시수요결합림상급기타검사결과종합판단。
Objective To investigate the 18F-FDG PET-CT imaging in the preoperative diagnosis and staging of regional lymph nodes in non-small cell lung cancer. Methods Sixty-four NSCLC patients underwent preoperative PET-CT and CT imaging on hilus of the lung and mediastinal lymph nodes. The imaging diagnosis was reviewed and compared with the pathological results. Results A total of 280 groups (828 lymph nodes) of lymph nodes were respected in 64 patients, during which, 34 groups (39 lymph nodes) of lymph nodes were confirmed as metastases by pathology. Twenty-five groups of lymph nodes were correctly defined as positive and 237 groups as negative by preoperative PET-CT imaging. Nine groups of lymph nodes were correctly defined as positive and 243 groups as negative by preoperative CT imaging. The sensitivity, specificity, accuracy, positive and negative predictive values for PET-CT and CT were 73.5%(25/34), 96.3%(237/246), 93.6%(262/280), 73.5%(25/34), 96.3%(237/246) vs 26.5%(9/34), 98.7%(243/246), 90.0%(252/280), 75.0%(9/12), 91.0%(243/267) respectively. The sensitivity and negative predictive values of the PET-CT and CT were statistical significance (P<0.05) .The accuracy rate of regional lymph nodes N0, N1, and N2 staging by PET-CT and CT were 88.4%(38/43), 20%(2/10), 81.8%(9/12) vs 93.0%(40/43), 20%(2/10), 45.4%(5/11) respectively. The accuracy rate of regional lymph nodes N2 staging by PET-CT was higher than by CT, but which was no statistical significance (P>0.05). The accuracy rate of regional lymph nodes N0, N1, and N2 staging by PET-CT was compared as the results, N0>N1 and N2>N1, which was obvious difference by pair-wise comparison (P<0.05). However, the accuracy rate of N0 and N2 staging has no statistical significance (P>0.05). Conclusions Preoperative PET-CT imaging is more accurate for the diagnosis and staging of metastatic lymph nodes in NSCLC than CT. But there are also partially of false positive and negative cases by PET-CT imaging. Therefore, clinical diagnosis should be integrated with the medical history and other examination.
