CAJ | 학술논문

目的探讨18F-FDG PET-CT显像在原发结外淋巴瘤中的诊断价值.方法回顾性分析139例临床疑似原发结外淋巴瘤患者的PET-CT显像结果,以病理学诊断为金标准,比较PET-CT、单纯CT、PET图像在诊断原发性结外淋巴瘤中的敏感性、准确性、特异性及符合率.按病理类型分组,将原发结外淋巴瘤患者最大标准摄取值进行比较,数据进行统计学分析.结果 139例患者中经病理证实原发结外淋巴瘤128例,结核、鼻咽癌、胃间质瘤、胃腺癌、肺腺癌、脑胶质瘤、骨髓纤维化、十二指肠腺癌各1例,其他类型转移癌3例.PET-CT诊断出真阳性病例106例,真阴性9例.PET-CT、CT、PET的敏感性分别为82.8％、65.6％、78.9％,特异性分别为81.8％、72.7％、36.4％,准确性分别为82.7％、66.2％、82.0％.PET-CT与CT比较,敏感性、准确性差异有统计学意义(x2值分别为9.881和10.006,P值分别为0.003和0.002);与PET比较,特异性差异有统计学意义(x2=4.487,P=0.034).PET-CT与CT比较,胃肠道淋巴瘤、头颈部淋巴瘤、弥漫大B细胞淋巴瘤(DLBCL)诊断符合率差异有统计学意义(x2值分别为5.110、5.278和8.711,P值分别为0.024、0.022和0.003).PET-CT在不同原发部位、不同病理分型结外淋巴瘤的诊断符合率差异无统计学意义(P＞0.05).按病理类型分组,黏膜相关淋巴瘤最大标准摄取值为7.4±4.6,与DLBCL(15.8±10.6)和NK/T细胞淋巴瘤(13.6±7.1)比较,差异均有统计学意义(P值均＜0.05),而DLBCL与NK/T细胞淋巴瘤相比差异无统计学意义(P＞0.05).结论 PET-CT在原发结外淋巴瘤的诊断中具有重要价值,但应注意鉴别诊断,且结果应结合病理诊断.
목적 탐토18F-FDG PET-CT현상재원발결외림파류중적진단개치.방법 회고성분석139례림상의사원발결외림파류환자적PET-CT현상결과,이병이학진단위금표준,비교PET-CT、단순CT、PET도상재진단원발성결외림파류중적민감성、준학성、특이성급부합솔.안병리류형분조,장원발결외림파류환자최대표준섭취치진행비교,수거진행통계학분석.결과 139례환자중경병리증실원발결외림파류128례,결핵、비인암、위간질류、위선암、폐선암、뇌효질류、골수섬유화、십이지장선암각1례,기타류형전이암3례.PET-CT진단출진양성병례106례,진음성9례.PET-CT、CT、PET적민감성분별위82.8％、65.6％、78.9％,특이성분별위81.8％、72.7％、36.4％,준학성분별위82.7％、66.2％、82.0％.PET-CT여CT비교,민감성、준학성차이유통계학의의(x2치분별위9.881화10.006,P치분별위0.003화0.002);여PET비교,특이성차이유통계학의의(x2=4.487,P=0.034).PET-CT여CT비교,위장도림파류、두경부림파류、미만대B세포림파류(DLBCL)진단부합솔차이유통계학의의(x2치분별위5.110、5.278화8.711,P치분별위0.024、0.022화0.003).PET-CT재불동원발부위、불동병리분형결외림파류적진단부합솔차이무통계학의의(P＞0.05).안병리류형분조,점막상관림파류최대표준섭취치위7.4±4.6,여DLBCL(15.8±10.6)화NK/T세포림파류(13.6±7.1)비교,차이균유통계학의의(P치균＜0.05),이DLBCL여NK/T세포림파류상비차이무통계학의의(P＞0.05).결론 PET-CT재원발결외림파류적진단중구유중요개치,단응주의감별진단,차결과응결합병리진단.
Objective To investigate the diagnostic value of 18F-FDG PET-CT imaging in primary extranodal lymphoma.Methods A retrospective analysis of 139 clinically suspected primary extranodal lymphoma patients examined by PET-CT and confirmed by biopsies was performed.Considering the pathological diagnosis as the gold standard,PET-CT imaging of all patients was compared with CT and PET to evaluate the efficacy of 18F-FDG PET-CT in detection of primary extranodal lymphoma.The maximal standardized uptake value (SUVmax) from primary extranodal lymphoma patients was compared,and the data were analyzed by x2 test.Results Of the total 139 analyzed cases,128 patients were confirmed to have primary extranodal lymphoma.The sensitivity,specificity and positive rate of PET-CT were 82.8％,81.8％and 82.7％,respectively,that of CT were 65.6％,72.7％ and 66.2％,and that of PET were 78.9％,36.4％and 82.0％,respectively.The sensitivity and accuracy of PET-CT were better than that of CT (x2=9.881,10.006; P=0.003,0.002).The specificity of PET-CT were better than that of PET (x2=4.487,P=0.034).In the gastrointestinal lymphoma,the sensitivity of PET-CT were better than that of CT (x2=5.110,P=0.024).In the head and neck lymphoma,the sensitivity of PET-CT were better than that of CT (x2=5.278,P=0.022).In the diffuse large B-cell lymphoma,the sensitivity of PET-CT were better than that of CT (x2=8.711,P=0.003).The SUVmax of mucosa-associated lymphoma was significantly different from that of diffuse large B-cell lymphoma and natural killer/T-cell lymphoma (7.4±4.6 vs 15.8±10.6,P=0.032; 7.4±4.6 vs 13.6±7.1,P=0.046),respectively.Conclusion 18F-FDG PET-CT imaging is important in the diagnosis of primary extranodal lymphoma,but the differential diagnosis with other disease is important,and the result should be combined with multiple biopsies.