18-FDG-PET对肺癌诊断和判断淋巴结转移的价值

目的探讨18-FDG-PET检查对肺癌定性的诊断和淋巴结转移情况诊断的价值,评估其对手术选择的参考意义。方法我院呼吸内科和胸外科96例疑似肺癌患者,在PET检查医师和患者双盲的情况下行18-FDG-PET,以病理检查结果作为金标准,对PET检查结果的漏诊率、误诊率、灵敏度、特异度等指标进行分析。结果对肺癌原发病灶的定性诊断误诊率为0,漏诊率为20.7%,灵敏度为79.3%,特异度为100%。对于肿瘤≤2cm的肿瘤漏诊率为20%。42例恶性疾病患者淋巴结转移误诊率为23.5%,漏诊率为40%,灵敏度为60%,特异度为76.5%。结论 PET对肺原发肿物定性诊断的误诊率低,特异性较好,但漏诊率较高,灵敏度尚待提高;对引流淋巴结定性诊断可为医生及患者决定是否手术治疗和手术方式提供有益的参考。对于不愿意接受针吸活检等有创性诊断的患者,先行PET检查是比较理想的选择。

The value of 18-FDG-PET for diagnosis and evaluating lymph node metastasis in primary lung cancer

Objective To analyze the result of 18-FDG-PET in the suspected lung cancer patients and evaluate its value for the surgeon therapy. Methods Total 96 suspected patients with lung cancer were enrolled into the research;the result was compared with the pathology result, the rate of missed diagnosis, the misdiagnosis rate, the sensitivity and specificity were calculated and analyzed. Results Compared with pathology results, the rate of missed diagnosis, the misdiagnosis rate,the sensitivity and specificity of PET for lung cancer were 0,20.7 %, 79.2 % and 100 % respectively.To those who have a neoplasm no more than 2 era, the misdiagnosis rate was high as 20%.To 42 lung cancer patients, the rate of missed diagnosis, the misdiagnosis rate, the sensitivity and specificity for lymph node metastasis were 23.5%, 40%, 60% and 76.5% respectively. Conclusion PET has a perfect specificity ancl a considerable sensitivity to lung cancer and similar to the lymph node metastasis diagnosis,it is an ideal chosen for those suspected lung cancer patients who reluctantly to accept a biopsy examination.