CAJ | 학술논문

目的对比分析18F-氟代脱氧葡萄糖(18F-FDG) PET/CT与增强CT诊断结直肠癌区域淋巴结转移的临床运用价值.方法回顾性分析2011年3月至2012年12月中山大学附属第一医院40例结直肠癌患者资料,所有患者均1周内行18 F-FDG PET/CT及增强CT检查,最终经病理检查证实.结果 40例结直肠癌患者中,经病理证实20例患者区域淋巴结转移.18 F-FDG PET/CT出现4例假阳性及3例假阴性,18 F-FDG PET/CT诊断结直肠癌淋巴结转移敏感性为85.0％ (17/20),特异性为80.0％(16/20),阳性预测值为81.0％(17/21),阴性预测值为84.2％(16/19),准确性为82.5％(33/40);腹部增强CT出现5例假阳性及8例假阴性,腹部增强CT诊断结直肠癌淋巴结转移敏感性为60.0％(12/20),特异性为75.0％ (15/20),阳性预测值为70.6％ (12/17),阴性预测值为65.2％(15/23),准确性为67.5％ (27/40);两者假阳性及假阴性经McNemar检验差异无统计学意义(P=0.344),两者敏感性及特异性差异亦无统计学意义(P=0.478,P=0.893;x2检验).结论虽然18F-FDG PET/CT在诊断结直肠癌淋巴结转移方面同增强CT相比有较高的敏感性、特异性及准确性,但差异无统计学意义,因此在临床工作中还需要根据患者情况选择适当的检查方法.
목적 대비분석18F-불대탈양포도당(18F-FDG) PET/CT여증강CT진단결직장암구역림파결전이적림상운용개치.방법 회고성분석2011년3월지2012년12월중산대학부속제일의원40례결직장암환자자료,소유환자균1주내행18 F-FDG PET/CT급증강CT검사,최종경병리검사증실.결과 40례결직장암환자중,경병리증실20례환자구역림파결전이.18 F-FDG PET/CT출현4례가양성급3례가음성,18 F-FDG PET/CT진단결직장암림파결전이민감성위85.0％ (17/20),특이성위80.0％(16/20),양성예측치위81.0％(17/21),음성예측치위84.2％(16/19),준학성위82.5％(33/40);복부증강CT출현5례가양성급8례가음성,복부증강CT진단결직장암림파결전이민감성위60.0％(12/20),특이성위75.0％ (15/20),양성예측치위70.6％ (12/17),음성예측치위65.2％(15/23),준학성위67.5％ (27/40);량자가양성급가음성경McNemar검험차이무통계학의의(P=0.344),량자민감성급특이성차이역무통계학의의(P=0.478,P=0.893;x2검험).결론 수연18F-FDG PET/CT재진단결직장암림파결전이방면동증강CT상비유교고적민감성、특이성급준학성,단차이무통계학의의,인차재림상공작중환수요근거환자정황선택괄당적검사방법.
Objective The aim of this study was to compare the diagnostic value of 18F-FDG PET/CT with contrast CT for regional lymph node metastasis of colorectal cancer.Methods Imaging results of 40 patients with colorectal cancer were retrospectively reviewed,and all the patients underwent both abdomen contrast CT and 18 F-FDG PET/CT imaging.Final diagnosis was made by histopathology.Results 20 colorectal cancer patients were verified with lymph node metastasis while the other 20 patients were absent.Finally,18 F-FDG PET/CT produced 4 false-positive patients and 3 false-negative patients.18 F-FDG PET/CT displayed sensitivity 85.0％ (17/20),specificity 80.0％ (16/20),positive predictive value 81.0％ (17/21),negative predictive value 84.2％ (16/19)and accuracy 82.5％ (33/40)in the diagnosis of lymph node metastasis.Contrast CT produced 5 false-positive patients and 8 false-negative patients.Contrast CT had the sensitivity 60.0％ (12/20),specificity 75.0％ (15/20),positive predictive value 70.6％ (12/17),negative predictive value 65.2％ (15/23) and accuracy 67.5％ (27/40).Sensitivity and specificity of PET/CT was better than of contrast CT,but no statistically significant difference between PET/CT and contrast CT (P =0.478,P =0.893 ; P =0.344.Fisher' s exact test and McNemar test).Conclusion Sensitivity and specificity of PET/CT was better than of contrast CT,but no statistically significant difference.Clinical works also need to select the appropriate inspection methods based on the patient's situation.