PET/CT与增强CT对肺癌淋巴结诊断及分期的比较

Comparison of nodal staging between PET /CT and CECT in patient with lung cancer

目的比较18F-FDG PET/CT与增强CT在肺癌淋巴结术前诊断及分期中的价值。方法以病理结果为金标准,比较82例肺癌患者术前PET/CT及增强CT检查者对区域淋巴结诊断及分期的效能。结果82例患者共切除区域淋巴结564枚,其中78枚(13.8%)证实为转移。PET/CT诊断区域淋巴结转移的灵敏度、特异度、准确度、阳性预测值及阴性预测值均显著高于增强CT,P均<0.05。PET/CT与增强CT对区域淋巴结分期总的准确性分别为[87.8%(72/82)及70.7%(50/82)],P<0.05;对区域淋巴结N0、N1、N2期诊断的准确性分别为[89.3%(25/28)、83.3%(20/24)、90.0%(27/30)]vs[85.7%(24/28)、50.0%(12/24)、73.3%(22/30)]。结论 PET/CT诊断区域淋巴结转移的效能高于增强CT,但是仍存在一定的假阳性及假阴性。临床工作中需要结合患者的临床资料,进一步提高诊断及分期的准确性。

Objective To compare the efficiency of ^18F-FDG PET /CT and CECT in lymph node staging for patients with lung cancer. Methods 82 patients with lung cancer underwent both PET /CT and chest CECT examination. With pathologic results as the gold standard,the efficiency in diagnosing and staging regional lymph nodes was compared. Results A total of 564 mediastinal lymph nodes were resected in 82 patients and 13. 8% were confirmed as metastases by pathology. PET /CT was superior to CECT in diagnosing regional lymph node（ P〈0. 05）. The accuracy of PET /CT and CECT in staging N0,N1,N2 was [89. 3%（ 25 /28）,83. 3%（ 20 /24）,90. 0%（ 27 /30） ]VS [85. 7%（ 24 /28）,50. 0%（ 12 /24）,73. 3%（ 22 /30） ]. Consistency of PET /CT and CECT in lymph node staging with pathological was respectively 87. 8%（ 72 /82） vs 70. 7%（ 50 /82）（ P〈0. 05）. Conclusion18F-FDG PET / CT is more accurate for evaluating metastatic lymph nodes and staging in patients with lung cancer than CECT.In our clinical work,integrated application of ^18F-FDG PET /CT and clinical data is needed.