^18F-FDG PET融合CT对胸中段食管鳞癌区域淋巴结分期的前瞻性研究

Prospective clinical research of ^18SF-fluorodeoxy-glucose PET combined CT in detecting district lymph node clinical stage of middle thoracic squamous cell esophageal carcinoma

目的 探讨正电子发射型电子计算机断层（PET）显像在胸中段食管鳞癌患者术前区域淋巴结临床分期中的应用价值。方法 30例行现代二野淋巴结清扫术的胸中段食管鳞癌患者，术前进行全身^18F-氟代脱氧葡萄糖（^18F-FDG）PET融合CT显像与CT显像，对区域淋巴结检查结果进行对照研究。结果 现代二野淋巴结清扫术后发现24例患者区域淋巴结阳性（80．00％），转移区域淋巴结总数为61枚。^18F-FDG PET融合CT发现食管区域淋巴结转移16例，敏感性、特异性和Youden指数分别为66．67％、100．0％和0．67。CT检出8例。61枚转移区域淋巴结中^18F-FDG PET融合CT定性43枚（70．49％），定量分析发现转移区域淋巴结计算标准化摄取值（SUV）为2．9±1．2，均〉2．5；CT检出区域淋巴结转移数24枚（39．34％）。^18F-FDG PET融合CT在区域淋巴结转移患者与区域淋巴结转移数均明显优于CT，P〈0．05。结论 ^18F-FDG PET融合CT在诊断胸中段食管鳞癌区域淋巴结转移方面可能优于CT。

Objective To evaluate the role of ^18F-FDG PET for district lymph node diagnose and clinical stage of middle thoracic squamous cell esophageal carcinoma. Methods 30 patients with squamous cell esophageal carcinoma in middle thoracic had modern two-field lymph node dissection. They underwent whole body ^18F-FDG PET combined CT imaging and CT imaging before operation. They were contrasted with the examination result of district lymph node. Results 24 patients （80. 00% ） in postopemtion of modern two-field lymph node dissection were found to be positive in district lymph node. The total number of metastatic district lymph nodes was 61. 16 of them were detected by ^18 F- FDG PET combined CT, the sensitivity, specificity and Youden index of ^18F-FDG PET combined CT were 66. 67% ,100. 0% ,0. 67 ,respectively. 8 of them were detected by CT. 43（70.49% ） lymph nodes were identified metastases in 61 by ^18F-FDG PET combined CT, and 24 （39. 34% ） by CT. The result of quantitative analysis showed metastatic district lymph node changed SUV as 2. 9±1.2,all 〉2. 5.^18F-FDG PET combined CT was more sensitive than CT in the patient and the number of metastatic district lymph nodes, P 〈0. 05. Conclusion ^18F-FDG PET combined CT is superior to CT in detecting district esophagus lymph node metastasis.