18F-FDG PET/CT检测淋巴结转移性鳞癌原发灶的价值

目的 探讨18F-氟脱氧葡萄糖（FDG） PET/CT在淋巴结转移性鳞癌原发灶检测中的临床应用价值。 方法 选取2018年3月至2020年11月于广东省佛山市禅城区中心医院因发现淋巴结转移性鳞癌而原发灶不明行全身18F-FDG PET/CT检查的56例患者进行回顾性研究，其中男性44例、女性12例，年龄19~81岁，中位年龄51岁。所有患者的淋巴结转移性鳞癌均于18F-FDG PET/CT显像前经组织病理学检查确诊，原发灶经组织病理学检查或临床随访确诊。分析并计算18F-FDG PET/CT检测原发灶的检出率；原发灶与淋巴结转移部位、最大标准化摄取值（SUV_max）的关系。采用双变量相关分析法分析原发灶与淋巴结转移灶的SUV_max的相关性。 结果 56例患者中，18F-FDG PET/CT检测原发灶阳性44例（真阳性42例、假阳性2例），检出率为75.0%；假阴性1例（鼻咽癌）；11例患者18F-FDG PET/CT未发现原发灶。双变量相关分析结果显示，原发灶与淋巴结转移灶的SUV_max在一定程度上具有一致性（r=0.320，P<0.05）。 结论 18F-FDG PET/CT显像对淋巴结转移性鳞癌的不明原发灶检测具有较好的临床应用价值，淋巴结转移灶与原发灶的18F-FDG代谢强度存在良好的相关性。

The value of 18F-FDG PET/CT imaging in detecting the primary foci of lymph node metastatic squamous cell carcinoma

Objective To investigate the clinical value of 18F-FDG PET/CT imaging in detecting primary foci by analyzing images of squamous carcinoma patients with lymph node metastatic. Methods A retrospective analysis was performed on 56 patients (44 males and 12 females, aged 19?81, with a median age of 51), who underwent whole-body 18F-FDG PET/CT for the diagnosis of metastatic squamous carcinoma with unknown primary foci during March 2018 to November 2020 at the Central Hospital of Chancheng District of Foshan City in Guangdong Province. Prior to imaging, the diagnosis of metastatic squamous cell carcinoma was confirmed by pathological examination in all patients, and the primary foci were confirmed by pathological examination or clinical follow-up. To analyze and calculate the detection rate of 18F-FDG PET/CT in the diagnosis of primary lesion and the relationship between primary lesion and lymph node metastasis and maximum standardized uptake value (SUV_max). SUV_max of primary tumor and lymph node metastasis were analyzed by bivariable correlation analysis. Results Among 56 patients, 44 positive cases (42 true positive cases and 2 false positive cases) were detected by 18F-FDG PET/CT, with a detection rate of 75.0% and 1 false negative (nasopharyngeal carcinoma). Primary foci in 11 patients remained unfound by 18F-FDG PET/CT. The SUV_max of primary and metastatic foci were consistent to some extent (r=0.320, P<0.05). Conclusion 18F-FDG PET/CT imaging has good clinical value for the detection of unspecified primary foci in metastatic squamous cell carcinoma, and there is a good correlation between the intensity of glucose metabolism in the primary foci and metastatic foci.