摘要
目的 探讨18F-FDG PET/CT在原发不明颈部淋巴结转移癌患者原发灶检出中的临床应用价值.方法 回顾性分析2007年至2012年间因颈部淋巴结细针穿刺活组织检查提示转移但原发不明而行18F-FDG PET/CT检查的患者78例,其中男48例,女30例,平均年龄(56.4±14.7)岁.在PET/CT图像上勾画ROI并计算SUVmax.将淋巴结分为Ⅰ～Ⅵ区、咽后区及锁骨上区,取淋巴结短径为其大小.患者均经病理、随访确诊.观察肿瘤原发灶部位、病理类型及转移淋巴结分布、大小及SUVmax.采用单因素方差分析及直线相关分析分析数据.结果 78例患者中,恶性75例,良性3例(手术切除后病理检查).56例患者由PET/CT检出原发灶,检出率为71.8％(56/78).其中头颈部肿瘤占57.1％(32/56),对应转移淋巴结多分布于Ⅱ、Ⅲ、Ⅳ区(90.6％,29/32);体部肿瘤占42.9％(24/56),对应转移淋巴结多分布于锁骨上区(95.8％,23/24).不同原发部位及不同病理类型的颈部转移淋巴结大小和SUVmax差异均无统计学意义(F=0.037～ 2.413,均P＞O.05).结论 18F-FDGPET/CT有利于判断原发不明肿瘤的大致部位,并了解全身病灶分布.
Objective To investigate the value of 18F-FDG PET/CT for the detection of primary malignancy in patients with cervical lymph node metastases from unknown origin.Methods Seventy-eight patients (48 males,30 females,average age (56.4± 14.7) years) who were diagnosed as cervical lymph node metastases from unknown origin by fine needle aspiration underwent 18F-FDG PET/CT from 2007 to 2012.ROI was drawn with SUVm~ calculated.The distribution of the lymph nodes was classified according to the standard levels Ⅰ to Ⅵ,as well as the retropharyngeal and supraclavicular stations.The short axis of lymph node was defined as the lesion size.The final diagnosis was confirmed by pathology and clinical follow-up.Data collection and interpretation included identification of primary malignancy,pathologic types of primary tumors,distribution,size and SUVmax of the metastatic lymph nodes.One-way analysis of variance and linear correlation analysis were used for data analysis.Results In 78 subjects,75 were diagnosed as having malignant and 3 as benign lymph nodes by excisional biopsy.18F-FDG PET/CT detected primary malignancy in 56 cases (71.8％,56/78).In these 56 cases,57.1％(32/56) had head and neck cancer with metastatic lymph nodes mainly distributed in levels Ⅱ,Ⅲ and Ⅳ (90.6％,29/32).The remaining 24/56 (42.9％) patients had primary malignancy of the trunk with metastatic lymph nodes primarily involving supraclavicular fossa (95.8％,23/24).There was no statistical difference in size and SUVmax of lymph node among different primary locations or pathological types (F=0.037-2.413,all P＞0.05).Conclusion 18FFDG PET/CT may play an important role in the detection of primary cancers for patients with metastatic cervical lymph nodes from unknown origin.
出处
《中华核医学与分子影像杂志》
CSCD
北大核心
2013年第6期-,共4页
Chinese Journal of Nuclear Medicine and Molecular Imaging
