^(18)F-FDG PET/CT对非小细胞肺癌患者临床分期的诊断价值及对治疗的指导作用

The diagnostic value of ^(18)F-FDG PET/CT in the clinical staging for non-small cell lung cancer and its guiding role in treatment

目的研究^(18)F-氟代脱氧葡萄糖(^(18)F-FDG)正电子发射计算机断层显像/计算机断层扫描(PET/CT)对非小细胞肺癌(NSCLC)临床分期的诊断价值及对治疗方面的指导作用。方法回顾性分析66例NSCLC患者的临床资料,所有患者分别进行增强CT和^(18)F-FDG PET/CT全身扫描,采用国际抗癌联盟(UICC)肺癌TNM分期标准对患者的临床分期进行评估,并与病理活检结果进行对比,比较二者对NSCLC患者TNM分期的诊断价值及对治疗方面的指导作用。结果 66例经病理证实的NSCLC患者中,增强CT对T、N分期的诊断符合率分别为78.8%、74.2%,均低于^(18)F-FDG PET/CT对T、N分期的诊断符合率92.4%、95.5%,差异均有统计学意义(P﹤0.05);增强CT和^(18)F-FDG PET/CT对M分期的诊断符合率分别为95.5%和98.5%,二者比较,差异无统计学意义(P﹥0.05)。^(18)F-FDG PET/CT漏诊M1期脑转移患者1例。结论^(18)F-FDG PET/CT是一种安全的非侵入性检查,将细胞代谢功能与病灶的解剖结构相结合,提高了对NSCLC患者临床T、N分期的诊断准确率,对临床治疗方案的选择具有指导作用。

Objective To explore the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography(18F-FDG PET/CT)in the clinical staging for non-small cell lung cancer(NSCLC)and its guiding role in the treatment.Method Clinical data of 66 patients with NSCLC were analyzed,retrospectively,both of enhanced CT and systemic 18F-FDG PET/CT detection were performed in all of the patients,the TNM staging criteria for lung cancer from Union for International Cancer Control were used for diagnoses and the results were compared to pathological biopsy results.The guiding roles of the two examinations in the clinical staging and treatment of NSCLC were compared.Result Among 66 patients of NSCLC confirmed by pathology,diagnostic accordance rates of T and N staging by enhanced CT were 78.8% and 74.2%,respectively,the diagnostic accordance rates of T and N staging by 18F-FDG PET/CT were 92.4% and 95.5%,respectively,and the differences were statistically significant(P<0.05).The diagnostic accordance rates of M staging by enhanced CT and 18F-FDG PET/CT were 95.4%and 98.5%,without statistical difference(P>0.05).18F-FDG PET/CT missed diagnosis of M1 stage brain metastasis in 1 patient.Conclusion 18F-FDG PET/CT is non-invasive and safe,combining the anatomical structure and metabolic function of tumor cells,which can improve the diagnostic accuracy rates of T,N staging in NSCLC patients with a guiding role for clinical treatment options.