^(18)F-FDG PET-CT对非小细胞肺癌TNM分期的价值

Value of PET-CT in staging of non-small cell lung cancer

目的探讨PET-CT显像对非小细胞肺癌(NSCLC)患者分期的价值。方法43例非小细胞肺癌患者行全身PET-CT显像,且于检查前一周内行胸部16层螺旋CT扫描。按照国际通用的AJCC(美国癌症联合委员会)肺癌TNM分期标准对病变分别行CT、PET-CT分期,并将组织病理结果作为参照标准。结果①对照病理结果,PET-CT对NSCLC的T分期比CT准确性更高(P<0.05)。43例肺癌T分期中,PET-CT正确分期41例,CT正确分期34例。②43例术前诊断分期的患者中,与病理符合的肺癌N分期,PET-CT40例,CT33例。PET-CT对肺癌的N分期与CT相比具有显著性差异(P<0.05)。③CT发现了8例患者的13处转移,PET-CT发现了14例患者的32处转移,改变了6例患者治疗计划。结论PET-CT显像用于NSCLC的分期是一可靠的非创伤性方法,对指导肺癌的临床治疗具有重要意义。

Objective To determine the accuracy of dual-modality positron emission tomographic （PET） -computed tomographic （CT） imaging, as compared to CT alone, in the staging of non-small cell lung cancer （NSCLC）. Methods PET-CT was performed on all of 43 patients. The uptake of ISF-FDG was analyzed and the disease stage was determined by using TNM and American Joint Committee on cancer staging systems. Histopathologic results served as the reference standard. The statistical significance of differences among CT and PET-CT was determined. Results①Primary tumor stage was correctly determined in more patients with PET-CT than CT alone （P〈0.05）. Overall tumor stage was correctly classified as T stage with CT in 34 patients and with PET-CT in 41 patients.②Overall tumor stage was correctly classified as N stage with CT in 33 patients and with PET-CT in 40 patients. Differences in the accuracy of overall tumor staging between PET-CT and CT were significant（P〈0.05）.③ 8 distant metastases were detected in 13 patients with CT, 32 distant metastases were detected in 32 patients with PET-CT. When compared with CT findings, PET-CT findings led to the change of treat-ment for 6 patients. Conclusion PET-CT significantly increases the number of patients with correctly stages NSCLC and thus has a positive effect on the treatment.