PET-CT在非小细胞肺癌术前评估区域淋巴结转移中的应用价值

Application value of PET-CT in preoperative assessment of regional lymph node metastasis in non-small cell lung cancer

目的:探讨正电子发射计算机断层显像/计算机断层扫描(PET-CT)在非小细胞肺癌术前评估区域淋巴结转移中的应用价值。方法:抽取2019年1月至2020年12月西安市胸科医院收治的168例非小细胞肺癌患者的临床资料进行回顾性分析。所有患者行手术治疗,术前接受增强CT扫描和18氟脱氧葡萄糖(18F-FDG)PET-CT,记录肺门纵隔淋巴结转移情况,术中采集病理组织标本开展病理检查,以病理结果为金标准,计算并比较两种检查方式的诊断效能。结果:168例非小细胞肺癌患者中,肺腺癌99例,鳞癌69例;58例出现肺门纵隔淋巴结转移,占比34.52%,110例未出现淋巴结转移。PET-CT诊断术前区域淋巴结转移157例(93.45%),增强CT诊断121例(72.02%)。PET-CT诊断准确度、敏感度、特异度高于增强CT(χ2=0.00、0.01,0.02,P均<0.05)。结论:PET-CT在非小细胞肺癌术前区域淋巴结转移评估方面有一定应用价值,优于增强CT检查,可为临床提供准确的参考信息,减少医源性损伤及过度医疗。

Objective:To investigate the application value of positron emission tomography/computed tomography(PET-CT)in preoperative assessment of regional lymph node metastasis in non-small cell lung cancer.Methods:The clinical data of 168 patients with non-small cell lung cancer admitted to Xi’an Chest Hospital from January 2019 to December 2020 were retrospectively analyzed.All selected patients were treated by surgery.The contrast-enhanced CT scans and 18F-fluorodeoxyglucose(18F-FDG)PET-CT were performed on them before surgery.The metastasis of hilar and mediastinal lymph nodes was recorded.Pathological tissue samples were collected during the operation for pathological examination.The diagnostic performance of the two examination methods were calculated and compared with the pathological results as the gold standard.Results:Among the 168 non-small cell lung cancer patients,99 cases had lung adenocarcinoma,and 69 cases had squamous cell carcinoma.There were 58 cases with hilar and mediastinal lymph node metastasis,accounting for 34.52%,and 110 cases without lymph node metastasis.In preoperative assessment,PET-CT detected out 157 cases(93.45%)with regional lymph node metastasis,and contrast-enhanced CT detected out 121 cases(72.02%).The accuracy,sensitivity and specificity of PET-CT were higher than those of contrast-enhanced CT(χ2=0.00,0.01,0.02;all P<0.05).Conclusions:PET-CT has certain application value in the preoperative evaluation of regional lymph node metastasis in non-small cell lung cancer,which is superior to enhanced CT examination.It can provide accurate reference information for clinical practice and reduce iatrogenic injury and overtreatment.