氟脱氧葡萄糖PET-CT对非小细胞肺癌纵隔淋巴结转移的诊断价值

目的　通过对非小细胞肺癌(NSCLC)患者纵隔淋巴结术前氟脱氧葡萄糖(18FDG)PET -CT检查和术后病理结果比较,探讨18FDGPET- CT在判断NSCLC纵隔淋巴结转移(淋巴结短径<10mm)方面的作用与价值。方法　12例经病理确诊的NSCLC患者术前行18FDGPET- CT检查,详细记录纵隔淋巴结转移情况,主要探讨短径<10mm的纵隔淋巴结转移情况。术后病理结果作为金标准对纵隔淋巴结转移情况进行验证。可以做分析的淋巴结共有76个。结果　76个淋巴结中,病理证实为阳性6个,病理证实为阴性的70个。PET- CT共检出5个真阳性、6 7个真阴性、3个假阳性、1个假阴性淋巴结。PET CT的敏感性为83.3% ,特异性为95 .7% ,准确性为94 .7%。阳性预测值为6 2 .5 % ,阴性预测值为98.6 %。结论　18FDGPET CT对短径<10mm的纵隔淋巴结是否转移的判断是准确和可信的,对NSCLC患者治疗方案的制订有较高的临床价值。

Value of 18FDG PET-CT in detecting the metastatic mediastinal lymph node in non-small cell lung cancer

Objective To evaluate the value of fluorodeoxyglucose ( 18FDG) PET -CT in detecting the micrometastatic mediastinal lymph node in non-small cell l ung cancer (NSCLC). Methods From April 2003 to October 2003,12 consecutive pati ents with pathologically proven NSCLC were examined by 18FDG P ET-CT preoperative ly to evaluate the mediastinal lymph nodes, of which the short diameter was less than 10?mm. The number and location of the metastatic mediastinal lymph-node was recorded. Postoperative pathology was taken as the "gold standard" to confirm t he image diagnosis of mediastinal lymph node. Results Of 76 recorded <10?mm lym ph nodes 6 were positive and 70 negative by pathology. By PET-CT: 5 were positi v e, 67 negative, 3 false positive and 1 false negative. The sensitivity and speci ficity of 18FDG PET-CT were 83.3% and 95.7% with a diagnostic accuracy of 94.7% . The positive and negative predictive values of PET-CT were 62.5% and 98.6%. Conclusions 18FDG PET-CT is reliable and accurate in detecting the micrometastatic mediastinal lymph-node. 18FDG PET-CT has great clinical val ue in guilding the management of NSCLC.