PET-CT与组织病理学在肺部肿物诊断中的对比分析

Comparison of preoperative PET-CT and pathological analyses in diagnosis of pulmonary tumors

目的:探讨^(18)F-脱氧葡萄糖正电子发射体层显像(^(18)F-FDG Positron emission tomography–computed tomogaprhy,^(18)F-FDG PET-CT)检查与组织病理学在可切除肺部肿物诊断中的一致性。方法 :回顾性纳入肺部肿物患者在术前PET-CT诊断和术后组织病理学诊断资料,对两种诊断方法在肺部肿物性质、纵隔淋巴结转移、肺门及肺内淋巴结转移等方面进行对比分析。结果:术前PET-CT与术后病理在肺肿物良恶性判断符合率为87.3%,一致性中等(κ=0.401,P<0.001),说明两种诊断方法在肺部肿物性质方面的结果差异无显著性(Mc Nemar检验结果P=0.508);术前PET-CT与术后病理在纵隔淋巴结转移符合率为85.9%,一致性中等(κ=0.697,P<0.001),两种诊断方法在纵隔淋巴结转移方面的结果差异无显著性(Mc Nemar检验结果 P=0.754);术前PET-CT与术后病理在肺门及肺内淋巴结转移符合率为77.4%,一致性中等(κ=0.523,P<0.001),两种诊断方法在肺门及肺内淋巴结转移方面的结果差异无显著性(Mc Nemar检验结果 P=0.454)。结论:术前PET-CT与组织病理学在肺部肿物诊断中有较好的一致性,在术式的选择提供具有一定指导意义的依据。

Objective To investigate the consistency in 18F-deoxyglucose positron emission tomography （18F-FDG PET-CT） examination and histopathological analyses in the diagnoses of resectable lung tumors. Methods Retrospective reviews over the clinical data of lung tumor patients by preoperative PET-CT diagnosis and postoperative histopathological diagnosis were conducted to investigate the effects of the two diagnostic methods in terms of lung tumor properties , mediastinal lymph node metastasis , and pulmonary hilar lymph node metastasis. Results The diagnoses by preoperative PET-CT was consistent in differentiation of non-malignancy and malignancy of pathologic lung tumors by 87.3%, at a medium level （κ = 0.401, P 〈 0.001）. McNemar test showed P = 0.508, indicating the two diagnostic methods were insignificantly different in the diagnosis of pulmonary tumors. The preoperative PET-CT was consistent in the diagnosis of the metastasis of pathologic mediastinal lymph node by 85.9%, at a medium level （κ = 0.697, P 〈 0.001）. McNemar test showed P =0.754, indicating no significant difference between the diagnostic methods. The preoperative PET-CT was consistent with postoperative pathological examinations in the differentiations of the metastasis of pulmonary and hilar lymph node by 77.4%, at a medium level （κ=0.523, P 〈 0.001）. McNemar test showed P = 0.454, indicating the two diagnostic methods were no significantly different. Conclusion Preoperative PET-CT and histopathologic examinations may be consistent in lung tumor diagnosis , which provides a basis for a certain significance in the surgical options.