^(18)F-FDG PET显像在非小细胞肺癌临床分期中的价值

Value of ^(18)F-FDG PET in clinical staging of non small cell lung cancer

目的探讨18F脱氧葡萄糖正电子发射体层显像(18FFDGPET)在非小细胞肺癌(NSCLC)临床分期中的价值。方法105例NSCLC患者于放射治疗前行18FFDGPET检查,进行PET分期,并将PET分期和CT分期结果进行比较分析。结果18FFDGPET扫描使38例NSCLC患者分期改变,其中分期升级31例,分期降级7例。21例分期升级者PET检查发现了远处转移灶,其治疗方案由根治性治疗改为姑息性治疗;6例分期降级者进行了根治性手术治疗,其中5例PET分期与病理分期一致。PET发现远处转移灶的几率随PET扫描前分期的升级而上升,其中Ⅰ期10.0%(2/20),Ⅱ期14.3%(3/21),Ⅲ期25.0%(16/64)。结论18FFDGPET显像改变了36.2%(38/105)NSCLC患者的临床分期,影响了其治疗策略。18FFDGPET显像对NSCLC患者的临床分期有重要的参考价值。

Objective To evaluate the feasibility of 18 F deoxyglucose positron emission tomography ( 18 F FDG PET) in the staging of non small cell lung cancer (NSCLC). Methods 105 patients with NSCLC had been examined by 18 F FDG PET and staged by PET before radiotherapy. The results of 18 F FDG PET examination were compared with those of CT. Results The staging was changed in 38 patients because of 18 F FDG PET findings with PET upstaged in 31 patients and downstaged in 7 patients. Because of distant metastasis detected by PET, 21 patients received palliative treatment. Six of the 7 downstaged patients underwent radical surgery, among which the PET findings were concordant with the operative findings in 5 patients. Distant metastasis detected by PET increased with elevation of pre PET stage: at stage Ⅰ 10.0%(2/20), stage Ⅱ 14.3%(3/21) and stage Ⅲ 25.0% (16/64), respectively. Conclusion 18 F FDG PET, by changing clinical staging in 36.2% (38/105) NSCLC patients has impact on treatment strategy in NSCLC patients.