^(18)F-FDG PET/CT评估鼻咽癌远处间隔转移、复发及效能分析

^(18)F-FDG PET/CT in evaluating diagnostic ability for distant metastasis of nasopharyngeal carcinoma

目的:对经18F-FDG PET/CT扫描的鼻咽癌患者远处转移及PET/CT诊断效能进行分析。方法:73例鼻咽癌分为原发未经治疗组和治疗组,分析鼻咽癌各组远处转移部位、发生率。采用5级分类诊断法,选取不同分级点作为截止点绘制ROC曲线,寻找最佳截止点评价诊断效能。结果:22例原发未经治疗组远间隔转移发生率为59.1%,51例治疗组远处间隔转移发生率为68.6%,两组比较有差异(P<0.01)。远处间隔转移最常见的部位依次是远处淋巴结(38.67%)、骨骼(36%)及肝脏(25.33%)。ROC曲线示以3级为最佳截止点PET/CT诊断效能较高。原发灶与复发灶SUV比较有统计学意义(P<0.01)。结论:鼻咽癌远处间隔转移发生率较高,最常见部位是远处间隔淋巴结,PET/CT诊断鼻咽癌远处转移的效能较高。

Objective： To evaluate distant metastasis of nasopharyngeal carcinoma （NPC） and analyze the diagnostic efficacy of ^18F- FDG PET/CT. Methods： Seventy-three patients were divided into two groups including primary patients without any treatment and patients after radiotherapy. The incidence of distant metastasis were analyzed between two groups. PET/CT images were classified V grades, and ROC curve was drawed to analyze the doctor using PET/Cr diagnostic ability. Results：The incidence of distant metastasis in the primary group was 59.1% and 68.6% in tile post radiotherapy gn）up and there were significant difference between groups（ P 〈 0.01）. The most three frequent distant metastasis sites were the distant lymph nodes （39.73 % ）, skeleton （36.98 % ）, liver （26.03 % ）, respectively. There were significant difference of the SUVmax between recurrence focus and primary focus （ P 〈 0.01）. The optimal sensitivity was 86.36 % and spocificiy was 88.24 % when cutoff point was Ⅲ grade. Conclusion：The incidence of distant metastasis is high and the most frequent site is distant lymph nodes. The intense level of primary focus is higher than that of recurrence focus after radiotherapy. ROC curve showed physicians using FDG PET/CT diagnosis efficacy was higher.