^(18)F-FDG PET/CT显像在非小细胞肺癌术前分期中的价值

Dual-modality PET/CT in the preoperative staging of non-small cell lung cancer

目的 评价1 8F 脱氧葡萄糖(FDG)PET CT显像在非小细胞肺癌(NSCLC)分期中的价值。方法 73例经病理检查证实的NSCLC患者行1 8F FDGPET CT显像。两诊断组盲法阅片,所得分期结果与病理检查和(或)随访结果比较、评分后进行统计学分析。结果 在总体分期准确性上,1 8F FDGPET CT优于CT、1 8F FDGPET(P均<0 0 0 1)及视觉融合分期(P =0 0 0 1)。2 5例患者获得T亚分期证实,在T亚分期准确性上,1 8F FDGPET CT优于CT、1 8F FDGPET及视觉融合分期(P =0 0 0 2、0 0 0 1、0 0 0 8)。2 9例患者获得N亚分期证实,在N亚分期准确性上,1 8F FDGPET CT优于CT(P =0 0 0 1) ,与1 8F FDGPET及视觉融合分期相比没有明显差别(P =0 12 5、0 2 19) ,但1 8F FDGPET CT与1 8F FDGPET和视觉融合相比分别在5例及4例患者中准确定位。在M亚分期上,1 8F FDGPET CT较CT、1 8F FDGPET探测到更多远处转移灶,且为后两者无法定位的患者准确定位。结论 1 8F FDGPET CT显像对NSCLC总体分期及T、N。

Objective To assess the value of dual-modality PET/CT imaging, compared with CT alone, PET alone and conventional visual fusion of CT and PET in the preoperative staging of non small cell lung cancer (NSCLC). Methods Seventy three patients who had accepted preoperative PET/CT examination were studied retrospectively, and they were diagnosed as with NSCLC by biopsy. Two groups performed blinded interpretation and came to the staging conclusion from the data of CT, PET, visual fusion and PET/CT separetely. The staging results were compared with pathology and (or) follow up results and graded by established criteria in advance. Finally, statistical analysis was done on the basis of these results. Results PET/CT was more accurate than CT alone, PET alone ( P <0 001), and visual fusion ( P =0 001) for diagnosing in all patients. Twenty five patients' diagnoses were confirmed by thoracotomy and pathological T staging. PET/CT was more accurate than CT alone ( P =0 002), PET alone ( P =0 001), and visual fusion of PET and CT ( P =0 008) in T staging. N staging was surgically established in 29 cases. In N staging, PET/CT was more accurate than CT alone ( P =0 001) and showed no significant difference compared with PET alone ( P =0 125) or with visual fusion of PET and CT ( P =0 219). But it was found that PET/CT helped PET and visual fusion to localize pathological lymph node in 5 and 4 cases, respectively. In M staging, PET/CT detected more lesions than CT alone did (39 vs. 25); at the same time PET/CT helped PET and visual fusion to localize lesions precisely. Conclusions PET/CT is superior to PET alone, CT alone, or visual fusion of PET and CT in determining overall staging and T, N, M staging of NSCLC. It's an effective and may become a new routine examination in the preoperative staging of NSCLC.