CAJ | 학술논문

目的：评价18F-FDG PET-CT显像对黑色素瘤患者综合治疗后随访的诊断及其预后的价值。方法对我院40例黑色素瘤综合治疗的患者，回顾18F-FDG PET-CT显像和常规影像学诊断结果，采用SPSS13.0统计学软件包进行统计分析，计数资料采用四格表的方法计算阳性预测值、阴性预测值、灵敏度、特异度、准确性、假阳性率、假阴性率。结合18F-FDG PET-CT与相应组织病理定性诊断，以ROC曲线确定黑色素瘤病灶最佳SUVmax。通过建立以性别、年龄、病灶SUVmax、治疗方法、淋巴结转移情况、病灶部位COX比例风险回归模型，分析影响整体生存率的因素。结果40例黑色素瘤患者18F-FDG PET-CT显像诊断的阳性预测值90%、阴性预测值100%、灵敏度86%、特异度96%、准确性90%；常规影像学诊断阳性预测值79%、阴性预测值72%、灵敏度65%、特异度78%、准确性73%%；黑色素瘤病灶最佳SUVmax为2.5；COX比例风险回归模型分析显示，病灶SUVmax(相对危险度RR=1.312,P=0.009)和淋巴结转移情况(RR=2.815,P=0.004)是影响整体生存率主要因素。结论18F-FDG PET-CT显像对黑色素瘤患者综合治疗后的诊断比常规影像学具有较高的灵敏度、特异度、准确性，对预后的评估具有重要价值。
목적：평개18F-FDG PET-CT현상대흑색소류환자종합치료후수방적진단급기예후적개치。방법대아원40례흑색소류종합치료적환자，회고18F-FDG PET-CT현상화상규영상학진단결과，채용SPSS13.0통계학연건포진행통계분석，계수자료채용사격표적방법계산양성예측치、음성예측치、령민도、특이도、준학성、가양성솔、가음성솔。결합18F-FDG PET-CT여상응조직병리정성진단，이ROC곡선학정흑색소류병조최가SUVmax。통과건립이성별、년령、병조SUVmax、치료방법、림파결전이정황、병조부위COX비례풍험회귀모형，분석영향정체생존솔적인소。결과40례흑색소류환자18F-FDG PET-CT현상진단적양성예측치90%、음성예측치100%、령민도86%、특이도96%、준학성90%；상규영상학진단양성예측치79%、음성예측치72%、령민도65%、특이도78%、준학성73%%；흑색소류병조최가SUVmax위2.5；COX비례풍험회귀모형분석현시，병조SUVmax(상대위험도RR=1.312,P=0.009)화림파결전이정황(RR=2.815,P=0.004)시영향정체생존솔주요인소。결론18F-FDG PET-CT현상대흑색소류환자종합치료후적진단비상규영상학구유교고적령민도、특이도、준학성，대예후적평고구유중요개치。
Objective To evaluate 18F-FDG PET-CT imaging to the diagnosis of melanoma patients comprehensive follow-up after treatment and prognostic value. Methods A total of 40 cases of melanoma patients with comprehensive treatment, review of 18F-FDG PET-CT imaging and conventional imaging diagnosis, to statistical analysis using SPSS13.0 statistical software package, count data using four case table method to calculate positive predictive value, negative predictive value, sensitivity, specific, accurate, false positive rate and false negative rate. In combination with 18F-FDG PET-CT and histopathological corresponding qualitative diagnosis, with ROC curve to determine the optimal SUVmax melanoma lesions. Through the establishment of gender, age, focal SUVmax, treatment, lymph node metastasis, lesion COX proportional hazards regression model, analyze the influencing factors of overall survival. Results 40 cases of melanoma patients 18F-FDG PET-CT imaging in the diagnosis of the positive predictive value of 90% and negative predictive value of 100%, 86%, 96%, specific sensitivity, accuracy of 90%; Conventional imaging in the diagnosis of positive predictive value, negative predictive value of 79%, 72%, 73%, 65%, 65%sensitivity, specific, accurate%;Melanoma lesions best SUVmax is 2.5;COX proportional hazards regression model analysis showed that lesions SUVmax (relative risk, RR=1.312, P=0.009) and lymph node metastasis (RR=2.815, P=2.815) is the main factor that affect the overall survival rate. Conclusion 18F-FDG PET-CT imaging to the diagnosis of melanoma patients after comprehensive treatment than conventional imaging has high sensitivity, specific, accurate, important value to the evaluation of prognosis.