PET/CT对NSCLC临床分期的作用及其对NSCLC精确放疗的影响

目的探讨PET/CT对非小细胞肺癌临床分期及靶区勾画的影响。方法选取2012年3月至2013年3月成都军区总医院收治的非小细胞肺癌患者100例作为研究对象,分别采用PET/CT和普通CT对患者进行检查并对其靶区进行勾画,确定其临床分期及各项计划参数,并比较两种方法对非小细胞肺癌患者精确放疗计划的影响。结果与CT检查结果比较,PET/CT组1a、1b、2a、2b期人数稍少于CT组,3a、3b期的人数稍多于CT组,但各个病期百分比比较差异无统计学意义(P>0.05),将CT检查结果作为标准比较,PET/CT检查后临床分期改变者10例,达10%,均为分期升高。PET/CT检测NSCLC的灵敏度为93.7%,准确度为93.0%。PET/CT检查所测得的VGTV、V20、MLD三项指标均显著低于单纯CT(t=7.385、2.304、36.472,P<0.05),Ds比较差异无统计学意义(t=0.730,P>0.05)。结论 PET/CT较CT对非小细胞肺癌的检测更为准确,其对于靶区的勾画更为准确,可减少放疗对正常肺组织损伤,较好的起到保护作用,同时避免放射性肺炎的发生。

The Influence of PET/CT on NSCLC Clinical Staging and NSCLC Precise Radiotherapy

Objective To discuss the influence of PET/CT on clinical staging and target area drawing of non-small cell lung cancer（NSCLC）. Methods Total of 100 cases of NSCLC patients admitted in Chengdu Military General Hospital from Mar. 2012 to Mar. 2013 were selected as research objects, PET/CT and common CT were applied respectively on inspection and drawing of target area, the clinical stages and each planning parameter were determined. The influence of the two different methods on NSCLC precise radiotherapy plan were compared. Results Compared with CT findings, patients at 1 a, lb, 2a, 2b stage in PET/CT group were slightly less, at 3a,3b stage was slightly more than the CT group, but the percentage of each stage of disease was not statistically significantly different （ P 〉 0.05 ）, setting the CT examination results as the standard,the clinical staging after PET/CT examination altered in 10 cases, up to 10%, all with elevated staging. PET/CT detection sensitivity was significantly higher than CT detection, false positive rate was signif icantly lower than CT detection, but the differences of both specificity and the false negative rate were not sta tistically significant（ P 〉 0.05 ）, VGTV, V20, MLD from PET/CT examination were significantly lower than the CT examination （ t = 7. 385,2. 304,36. 472, P 〈 0.05 ）, Ds difference was not statistically significant （ t = 0. 730, P 〉 0.05 ）. Conclusion PET/CT has a better accuracy on NSCLC examination, also better on drawing of the target area,which can decrease the injury of radiotherapy on normal lung tissue to obtain a good protective effect, and avoid the occurrence of radioactive pneumonia in the mean time.