^18F-FDGPET／CT多次显像在监测和预测非小细胞肺癌术后复发和转移中的价值

Prediction of postoperative recurrence and metastasis with 18F.FDG PET/CT in patients with nonsmall cell lung cancer

目的探讨^18F-FDGPET／CT多次显像在监测和预测NSCLC术后复发和转移中的价值。方法NSCLC患者85例（男64例，女21例；平均年龄58．0岁），分别于术前1周内和术后3个月接受多次全身^18F—FDGPET／CT显像。肿瘤复发和转移的诊断经病理学确诊或经多种影像学综合诊断并经临床随访证实。计算^18F—FDGPET／CT显像的诊断效能，统计学分析采用疋。检验和两独立样本t检验。结果85例患者中，肿瘤复发和转移43例，无复发和转移42例。PET／CT在半年内检出率为9.3％（4／43），1年内为30．2％（13／43），2年内为76．7％（33／43），2年以上为97．7％（42／43），未检出2。3％（1／43）。18F-FDGPET／CT对NSCLC复发和转移的诊断灵敏度、特异性、准确性分别为97．7％（42／43）、95．2％（40／42）和96．5％（82／85）。术前肿瘤分期、原发灶大小和原发灶SUVmax是2年内肿瘤复发和转移的影响因素似。12．360，t=3．281和2．465，均P〈0．05），而性别、年龄和病理类型对其则均无明显影响。0．639、0．012和3．800，均P〉0．05）。结论^18F—FDGPET／CT多次显像有助于监测NSCLC术后复发和转移；术前肿瘤分期、原发灶大小及原发灶SUV。为2年内发生肿瘤复发和转移的影响因素。

Objective To assess the clinical value of lSF-FDG PET/CT for the prediction of postop- erative recurrence and metastasis in patients with NSCLC. Methods Eighty-five patients （64 males, 21 fe males; average age： 58.0 years） with NSCLC were enrolled. All patients underwent 1SF-FDG PET/CT within one week before surgical operation and 3 months after the operation. The diagnosis of recurrent cancer and me- tastasis was confirmed by pathologic findings, other imaging medalities and clinical follow-up. The diagnostic efficacy of PET/CT was calculated and the predictors for postoperative recurrence and metastasis were ana lyzed. X2 test and two-sample t test were used for statistical analysis. Results Among 85 patients, 43 had re-currence and metastasis post operation. The postoperative recurrence and metastasis were detected by 18F-FDG PET/CT in 9.3%（4/43） within 6 months, 30.2%（13/43） within 1 year, 76.7%（33/43） within 2 years and 97.7%（42/43） after 2 years. The sensitivity, specificity, accuracy of lSF-FDG PET/CT for the detection of recurrent tumor and metastasis were 97.7% （42/43）, 95.2% （40/42）, 96.5% （82/85） respectively. The pre-operative cancer staging, size and SUVmax of primary tumor were significant factors for the prediction of postop erative tumor recurrence and metastasis within 2 years （X2= 12.360, t = 3.281 and 2.465, all P〈0.05）, but not gender, age or pathological findings （X2=0.639, 0.012 and 3.800, all P〉0.05）. Conclusions lSF-FDG PET/CT has an important role for the detection of postoperative recurrence and metastasis in patients with NSCLC. Preoperative cancer staging, size and SUVmax of the primary tumor might be the predictive factors for postoperative tumor recurrence and metastasis within 2 years.