(18)^F-FDG PET/CT代谢参数对非小细胞肺癌纵隔淋巴结转移的诊断价值

Diagnostic Value of(18)^F-FDG PET/CT Metabolic Parameters for Mediastinal Lymph Node Metastasis in Non-small Cell Lung Cancer

目的:探讨(18)^F-FDG PET/CT代谢参数对非小细胞肺癌(non-small cell lung cancer,NSCLC)纵隔淋巴结转移的诊断价值。方法:回顾性分析锦州医科大学附属第一医院2019年4月-2020年12月经病理证实为NSCLC患者44例,收集患者淋巴结图像信息共198枚,记录其PET/CT代谢参数。根据病理结果将相应淋巴结分为转移组(n=48)和非转移组(n=150),统计学方法应用t检验或Mann-Whitney U检验及logistic回归分析,建立联合诊断模型,并绘制联合诊断模型与传统诊断模型的ROC曲线,通过对比曲线下面积AUC值比较两种方法的诊断效能。结果:两组淋巴结短径、早期显像最大标准化摄取值(SUVmax)、最大滞留指数(RImax)、早期淋巴结SUVmax/纵隔SUVmean(早期SUV L/M)、肿瘤代谢体积(MTV)、病灶糖酵解总量(TLG)比较,差异均有统计学意义(P<0.05),通过logistic回归分析,最终早期SUVmax和RImax两项参数被纳入联合诊断模型,AUC值0.947,敏感度和特异度分别为0.875和0.873,诊断效能较高。结论:早期SUVmax和RImax在预测NSCLC纵隔淋巴结转移中有一定的临床价值。

Objective:To investigate the diagnostic value of(18)^F-FDG PET/CT metabolic parameters in mediastinal lymph node metastasis of non-small cell lung cancer.Method:Retrospective analysis was performed on 44 patients with pathologically confirmed NSCLC in the First Affiliated Hospital of Jinzhou Medical University from April 2019 to December 2020,and PET/CT images of 198 lymph nodes were collected.According to the pathological results,corresponding lymph nodes were divided into the metastatic group(n=48)and the non-metastatic group(n=150).Statistical methods t test or Mann-Whitney U test and logistic regression analysis were used to establish the joint diagnosis model,and the ROC curve of the joint diagnosis model and the traditional diagnosis model was drawn.The diagnostic efficiency of the two methods was compared by comparing the AUC value of the area under the curve.Result:There were statistically significant differences in short diameter,early SUVmax,maximum retention index(RImax),early lymph node SUVmax/mediastinal SUVmean(early SUV L/M),tumor metabolic volume(MTV),total glycolysis volume of lesions(TLG)in two groups(P<0.05).Through logistic regression analysis,the early SUVmax and RImax parameters were finally included in the joint diagnosis model,with an AUC value of 0.947,sensitivity and specificity of 0.875 and 0.873,respectively.The diagnostic efficiency was higher than traditional diagnostic criteria.Conclusion:Early SUVmax and RImax have certain application value in predicting mediastinal lymph node metastasis of NSCLC.