18F-FDG PET-CT显像在预测肺癌淋巴结分期中的价值

目的:探究18F-FDG PET-CT显像在肺癌患者淋巴结分期中的预测价值。方法:以35例经手术病理证实为肺癌患者的PET-CT资料及临床资料为研究对象。在PET-CT原发灶及纵隔淋巴结各区最浓聚的部位勾画感兴趣区,得出SUVmax.以淋巴结转移进行分组,采用t检验、Wilcoxon rank-sum检验及四格表资料的Fisher确切概率法分析组间淋巴结SUVmax、淋巴结与原发灶SUVmax的比值(SUVratio)及临床特征的差异。用ROC曲线对PET/CT的预测价值进行分析。结果:患者年龄、性别、吸烟史、组织类型与肺门、纵隔淋巴结转移无显著相关(P>0.05)。转移淋巴结的SUVmax较非转移淋巴结显著升高,差异有统计学意义(P<0.05),而淋巴结的SUVratio与淋巴结转移无明显相关(P>0.05)。取淋巴结SUVmax的最佳阈值,假阴性患者中的肺癌原发灶SUVmax偏低,假阳性患者比假阴性患者中的吸烟率高,但不具有显著统计学意义(P>0.05)。结论:淋巴结SUVmax可以为临床判断淋巴结转移提供定量指标。结合患者的临床病理特征判断淋巴结的转移可能从--定程度上减少假阳性率及假阴性率。

The Value of 18F-FDG PET/CT in Predicting Lymph Node Staging of Lung Cancer

Purpose:To explore the predictive value of 18F-FDG PET-CT imaging in lymph node staging of patients with lung cancer.Methods:PET/CT and clinical data of 35 patients with lung cancer confirmed by surgeryand pathology results were used as the research objects.The area of interest was delineated on the PET/CT images where the primary lesion was the most obvious and the mediastinal lymph nodes were the most concentrated,and the maximum standard uptake value(SUVmax)was obtained.The differences in SUVmax,SUVratio and clinical characteristics between the groups were analyzed by t-test,Wilcoxon rank-sum test and Fisher's exact probability method.The predictive value of PET/CT was analyzed using ROC analysis.Results:There was no significant correlation between age,gender,smoking history,tissue type and hilar and mediastinal lymph node metastasis(P>0.05).SUVmax of metastatic lymph nodes was significantly higher than that of non-metastatic lymph nodes and the difference was with statistical significant(P<0.05),while SUVratio of lymph nodes was not significantly correlated with lymph node metastasis(P>0.05).The optimal threshold value of SUVmax in lymph nodes was obtained.The primary SUVmax of lung cancer in patients with false negative was lower,and the smoking rate of patients with false positive was higher than that of patients with false negative,but it was not with statistical significant(P>0.05).Conclusion:Lymph node SUVmax can provide a quantitative index for clinical diagnosis of lymph node metastasis.Combining with the clinicopathological features of the patients,it is possible to determine lymph node metastasis with lower the false positive rate and false negative rate to a certain extent.