最大标准摄取值诊断非小细胞肺癌纵隔淋巴结转移的最佳界值

目的 探讨18F-FDG PET/CT最大标准摄取值(SUVmax)诊断非小细胞肺癌(NSCLC)纵隔淋巴结转移的最佳临界值.方法 回顾性分析130例NSCLC初诊患者共337个纵隔淋巴结的术前PET/CT资料,以术后病理结果为对照,根据淋巴结SUVmax绘制SUVmax的ROC曲线,计算NSCLC纵隔淋巴结转移的最佳SUVmax诊断界值.结果 337个纵隔淋巴结中,病理确诊为转移性淋巴结129个(129/337,38.28％),无转移淋巴结208个(208/337,61.72％).纵隔淋巴结SUVmaxROC曲线下面积为0.842.当SUVmax为4.5时Youden指数最大(0.605),准确率最高(81.6％).结论 18F-FDG PET/CT诊断NSCLC纵隔淋巴结转移的最佳临界值SUVmax≥4.5较为合适.

Optimal threshold in diagnosing mediastinal lymph node metastasis of non-small cell lung cancer with maximum standardized uptake value

Objective To explore the optimal threshold in diagnosing mediastinal lymph node metastasis of non-small cell lung cancer(NSCLC) with PET/CT maximum standardized uptake value(SUVmax).Methods A total of 337 mediastinal lymph nodes from 130 histologically proved NSCLC patients without any therapy underwent 18F-FDG PET/CT,and the data were retrospectively reviewed,taking postoperative pathologic results as gold standards.According to SUVmax of mediastinal lymph nodes,ROC curves were drawn out to determine the SUVmax critical value,then put forward the best diagnostic threshold in diagnosing mediastinal lymph nodes metastasis in NSCLC by PET/CT.Results Among 337 mediastinal lymph nodes,129(129/337,38.28%) lymph nodes were diagnosed malignant and 208(208/337,61.72%) were benign by pathological diagnosis.According to SUVmax,the area under ROC curve was 0.842.When SUVmax was 4.5,Youden index was maximum(0.605),and the accuracy was the highest(81.6%).Conclusion The best threshold of SUVmax ≥4.5 to distinguish benign and malignant mediastinal lymph node is relatively appropriate by 18F-FDG PET/CT for NSCLC.