18F-FDG PET/CT对喉癌的诊断价值

目的探讨18F-FDG PET/CT对喉癌的诊断价值。方法 47例喉癌或喉癌疑似患者治疗前一周内接受18F-FDG PET/CT检查,比较18F-FDG PET/CT及同机平扫CT对喉癌诊断、分期的临床价值。结果 47例患者中,43例经病理学检查确诊为喉癌。PET/CT与同机平扫CT诊断喉癌原发灶的灵敏度分别为95.3%、74.4%,特异性分别为75%、50%,准确性分别为93.6%、72.3%,其中灵敏度及准确性的差异有统计学意义(χ2=7.340,P=0.007;χ2=7.532,P=0.006)。43例喉癌患者中,以患者为单位计算,26例伴区域淋巴结转移,PET/CT与同机平扫CT的灵敏度分别为92.3%、61.5%,两者的差异有统计学意义(χ2=6.933,P=0.008);以淋巴结分区为单位计算,19例手术患者共切除46组区域淋巴结,病理学检查证实为淋巴结转移25组,PET/CT与同机平扫CT的灵敏度分别为92%、64%,两者的差异有统计学意义(χ2=5.71,P=0.017)。PET/CT发现了1例双重癌,改变了治疗方案。依据18F-FDG PET/CT显像结果,34.9%患者改变了临床分期,其中14例提高了临床分期、1例降低了临床分期。结论 18F-FDG PET/CT不仅可以对绝大多数喉癌做出明确诊断,而且可以清楚显示肿瘤的侵犯范围、检出肿瘤转移灶,对喉癌的诊断及临床分期均具有重要的应用价值。

Value of 18F-FDG PET/CT in the diagnosis of laryngeal carcinoma

Objective To assess the clinical value of 18F-FDGPET/CT in the diagnosis of larynx carcinoma.Methods Forty-seven patients with larynx carcinoma or suspected larynx carcinoma underwent 18F-FDG PET/CT examination within a week before therapy.The value of 18F-FDG PET/CT in the diagnosis and staging of the malignancy was compared with that of unenhanced contrast CT.Results Among the 47 patients,a definite diagnosis of larynx carcinomas was established pathologically in 43 patients.For detection of primary tumors,the sensitivity,specificity and accuracy of 18F-FDG PET/CT were 95.3%,75% and 93.6%,as compared with 74.4%,50%,and 72.3% with unenhanced contrast CT scan,respectively,showing significant differences in the diagnostic sensitivity and accuracy between the two modalities(χ2=7.340,P=0.007;χ2=7.532,P=0.006).Twenty-six of the 43 patients were identified to have lymph node metastasis,for which 18F-FDG PET/CT showed a significantly higher diagnostic sensitivity than unenhanced contrast CT(92.3% vs 61.5%,χ2=6.933,P=0.008).In the 46 excised lymph nodes from 19 patients,26 were found positive for metastasis,for which 18F-FDG PET/CT showed a diagnostic sensitivity of 92%,significant higher than that with unenhanced contrast CT(64%,χ2=5.71,P=0.017).PET/CT detected synchronous tumor in one case.18F-FDG PET/CT resulted in a change of staging in 34.9% of the patients,including upstaging in 14 patients and down-staging in one patient.Conclusion 18F-FDG PET/CT can be an important means for diagnosis and initial staging of larynx carcinoma.