氟代脱氧葡萄糖正电子发射断层扫描CT全身显像对喉癌病灶或淋巴结转移诊断效能的影响

Effect of fluorodeoxyglucose positron emission tomography CT whole body imaging on the diagnostic performance of laryngeal cancer lesions or lymph node metastasis

目的探讨氟代脱氧葡萄糖正电子发射断层扫描CT(^(18)F-FDG PET-CT)全身显像对喉癌病灶或淋巴结转移术前诊断价值。方法选取128例我院2019年8月至2021年8月就诊的高度疑似喉癌患者作为研究对象,入院后均行^(18)F-FDG PET-CT检查及CT平扫+增强检查,以手术病理或喉镜活检结果为“金标准”,比较^(18)F-FDG PET-CT检查及CT平扫+增强检查对喉癌病灶及淋巴结转移诊断结果,并比较2种方法对不同TNM分期喉癌病灶检出率。结果经手术病理及喉镜活检结果显示,128例疑似喉癌患者中,阳性106例,淋巴结转移63例;经^(18)F-FDG PET-CT检查,阳性104例,淋巴结转移61例;经CT平扫+增强检查,阳性92例,淋巴结转移52例;与CT平扫+增强扫描对喉癌病灶诊断灵敏度83.0%、准确度82.8%比较,^(18)F-FDG PET-CT检查诊断灵敏度95.3%、准确度93.8%较高(P<0.05);与CT平扫+增强扫描对淋巴结转移诊断灵敏度73.0%、准确度78.3%比较,^(18)F-FDG PET-CT检查诊断灵敏度88.9%、准确度88.7%较高(P<0.05);与CT平扫+增强扫描比较,^(18)F-FDG PET-CT检查对于T2、T3期喉癌病灶检出率较高(P<0.05)。结论^(18)F-FDG PET-CT全身显像可有效提高喉癌病灶及淋巴结转移诊断效能,临床可通过其进行术前病情分期评估,以制定相应手术方案,改善预后。

Objective To investigate the value of fluorodeoxyglucose positron emission tomography CT(^(18)F-FDG PET-CT)whole body imaging in the preoperative diagnosis of laryngeal cancer lesions or lymph node metastasis.Methods One hundred and twenty-eight patients with highly suspected laryngeal cancer who were treated in our hospital from August 2019 to August 2021 were selected as the research subjects.After admission,^(18)F-FDG PET-CT examination and CT plain scan+enhanced examination were performed.The results of microscopic biopsy are the"gold standard".The results of^(18)F-FDG PET-CT examination and CT plain scan+enhanced examination in the diagnosis of laryngeal cancer lesions and lymph node metastasis were compared,and the detection rates of the two methods in different TNM stages of laryngeal cancer lesions were compared.Results The results of surgical pathology and laryngoscopy showed that among the 128 suspected laryngeal cancer patients,106 cases were positive and 63 cases were lymph node metastasis.By^(18)F-FDG PET-CT examination,104 cases were positive and 61 cases were lymph node metastasis;+Enhanced examination,92 cases were positive,and 52 cases were lymph node metastasis.Compared with CT plain scan+enhanced scan in the diagnosis of laryngeal cancer lesions with a sensitivity of 83.0%and an accuracy of 82.8%,^(18)F-FDG PET-CT had a diagnostic sensitivity of 95.3%and an accuracy of 93.8%higher(P<0.05).Compared with CT plain scan+enhanced scan for lymph node metastasis,the diagnostic sensitivity was 88.9%and the accuracy was 88.7%(P<0.05).Compared with CT plain scan+enhanced scan,^(18)F-FDG PET-CT examination has a higher detection rate for T2 and T3 laryngeal cancer lesions(P<0.05).Conclusion^(18)F-FDG PET-CT whole-body imaging can effectively improve the diagnostic efficiency of laryngeal cancer lesions and lymph node metastasis.It can be used for preoperative staging assessment in order to formulate corresponding surgical plans and improve prognosis.