摘要
目的 研究评价^(99m)Tc-MIBI SPECT术前诊断肺癌及纵隔转移淋巴结的价值。方法 随机选取本院胸外科l997年3月~2000年12月间初诊“肺部阴影待查”患者100例,术前常规检查并加行^(99m)Tc-MIBI SPECT检查。男80例,女20例,平均年龄57.61±10.99岁。肺癌手术中规范清扫纵隔各组淋巴结,光学显微镜观察。计算核素断层显像之诊断敏感性,特异性,准确性,阳性预测值,阴性预测值,阳性拟然比、阴性拟然比等指标。对转移淋巴结假阴性显像,配对进行淋巴结图像分析,获取各切片转移癌细胞的面积值(μm^2)及其面积百分比。结果(1)^(99m)Tc-MIBI SPECT对支气管肺癌的诊断评价:敏感性(93.67%),特异性(61.90%),准确性(87.00%),阳性预测值(90.24%),阴性预测值(72.22%),阳性拟然比(2.47)及阴性拟然比(0.10)。(2)^(99m)Tc-MIBI SPECT对纵隔转移淋巴结的诊断评价:敏感性(85.19%),特异性(93.62%),准确性(90.54%),阳性预测值(85.19%),阴性预测值(93.62%),阳性拟然比(13.28)及阴性拟然比(l3.28)及阴性拟然比(0.16)。(3)淋巴结图像分析显示:淋巴结中转移癌细胞的数量同显像与否既有一定联系又非密切相关,淋巴结癌细胞数量(面积)并不是其显像与否的唯一因素。结论 本组显示了SPECT在肺癌诊断鉴别和纵隔转移淋巴结预测上的独特价值。
ve To evaluate the value of ^(99m)Tc-MIBISPECT in diagnosis of lung cancer and in pre-operative prediction ofmediastinal metastatic lymph nodes.To explore the pathologic baseof Technetium-99m-MIBI SPECT in diagnosing lung cancer andmediastinal metasatic lymph node.Methods 100 patients(80men,20 women;mean age 57061 yr)diagnosed'lung fieldshadow' were enrolled in this study. After the chest image of ^(99m)Tc-MIBI SPECTW,every patient underwent the operation, including the lung focus and mediastinal lymph nodes resection.The pathologicalresults were compared the pre-operative^(99m)Tc-MIBI SPECT image toobtain the statistic quota of diagnostic test.Results Thesensitivity, specificity and accuracy ofv(99m)Tc-MIBI SPECT were93.67%, 6l.90% and 87.00% respectively in lung cancer and85.l9%, 93.62% and 90.54%, respectively in mediastinalmetastatic lymph node. The pathologic study showed that the amountof metastasis in lymph node was related to the result of ^(99m)Tc-MIBISPECT in diagnosing mediastinal metastatic lymph node, but not theexclusive factor. Conclusion The ^(99m)Tc-MIBI SPECT is an usefuland noninvasive method for differentially diagnosing lung cancer andfor predicting mediastinal metastatic lymph node, and will give thesurgeons guidance to resect the mediastinal metasatic lympli nodes.
出处
《肿瘤》
CAS
CSCD
北大核心
2001年第6期468-469,共2页
Tumor
基金
上海市卫生科研基金项目(98246)
关键词
肺癌
核素断层显像
纵隔淋巴结
病理学
Lung cancer
99tn Tc-MIBI SPECT
Mediastinal lymph node
Pathology