标准摄取值在诊断肺占位性病变中的价值及其影响因素

Standardized uptake value and influencing factors in diagnosis of lung neoplasms and its effect agents

目的 评价不同阈值的标准摄取值 (SUV )对肺占位性病变的诊断价值 ,并对肿瘤病理类型、病灶大小对SUV的影响机制进行初步探讨。方法 对 48例肺部占位性病变行PET显像的患者 (均未经手术及放、化疗 )及 2 0例健康体检者进行分析。结果 肺癌组、肺部良性病变组、正常对照组间SUV均有显著性差异 (P <0 .0 5 ) ,且肺癌组 >肺部良性病变组 >正常对照组。结合临床资料PET诊断肺部占位性病变的灵敏度为 93 .62 % ,特异性为 77.0 8% ,阳性预测值 83 .0 2 % ,阴性预测值 82 .3 5 %。结论 以SUVmax <2 .5作为肺部结节良、恶性的鉴别诊断标准可获得较好效果。肿瘤大小对SUV影响较大 ,两者呈正相关。

Objective To investigate the diagnostic value of standardized uptake value (SUV) of lung neoplasms, and to discuss relative affected factors such as pathological types and lesions sizes. Methods 18 F FDG PET was performed on 48 patients with lung occupying lesions and 20 normal subjects. All patients had results of pathology or follow up (6 months to 3 years) for analysis. Results There were significant differences of SUV among lung cancer group, lung benign lesion group and normal group each other ( P <0.05). Lung cancer group had the highest average value of SUV, but normal group had the lowest one. Combined with other clinical materials, the sensitivity of PET on lung neoplasms was 93.62%, the specificity was 77.08%, the positive predictive value was 83.02% and the negative predictive value was 82.35%. There was no significant difference of SUV between adenocarcinoma and squamous carcinoma ( P >0.01). There were significant differences of SUV between group with <2.0 cm lesion and groups with ≥2.0 cm lesion ( P <0.01). Lesion size and SUV had positive correlation (correlation coefficient: 0.70). Conclusion Taking SUVmax 2.5 as threshold, benign and malignant lung occupying lesions can be differentiated effectively. Lesion size is an important affecting factors of SUV.