摘要
目的探讨18氟-脱氧葡萄糖双探头符合线路单光子计算机断层显像术(18F-FDGSPECT)与增强螺旋CT联合对肺癌淋巴结转移分期的诊断价值。方法163例考虑为肺癌的患者2周内均行18F-FDGDHC-SPECT显像及胸部增强螺旋CT检查,3周内完成外科手术和病理学检查,并将组织病理结果作为参照标准对这两种方法进行比较。结果SPECT真阳性50例,真阴性61例,诊断肺癌淋巴结转移的灵敏度、特异度、阳性预计值、阴性预计值分别为52.6%、89.7%、83.3%、57.7%;CT真阳性44例,真阴性58例,诊断肺癌淋巴结转移的灵敏度、特异度、阳性预计值、阴性预计值分别为46.3%、85.3%、81.5%、53.2%。SPECT对肺癌的N分期与CT相比无显著性差异(P﹥0.05)。结论18F-FDGSPECT和CT作为非创伤性诊断方法在肺癌临床N分期中准确率较低,但这两种检查的联合使用可作为判断肺癌淋巴结有无转移的一种手段。
Objective To evaluate the diagnostic value of ^18F-FDG SPECT and CT in lymph node staging of lung cancer. Metheds Thoracic ^18F-FDG SPECT and enhanced thoracic CT were performed in 163 patients with suspected lung cancer in three weeks before thoraeotomy with hilar and mediastinal lymph nodes dissection and pathologic examination. According to the TNM of AJCC, the histological examination of lymph nodes sampled from thoracotomy was used as the reference standard for lymph node metastasis staging in order to compare with the results of ^18F-FDG SPECT and enhanced thoracic CT. Results Intake ratio of R ≥ 1.5 and the diameter of lymphnode 〉 1.0 cm were used as positive standard for ^18F-FDG SPECT and enhanced thoracic CT respectively of 163 patients, the sensitivity, accuracy and Youden index of ^18F-FDG SPECT and enhanced thoracic CT were 52.6%, 89.7%, 68.1%, 0.432 and 46.3%, 85.3%, 62.6%, 0.316 respectively. There was no diffenece between ISF-FDG SPECT and CT imaging in diagnosis and staging of patients with lyng cancer（P=0.245）. Condusions Neither ^18F-FDG SPECT nor enhanced thoracic CT of mediastinal lymph nodes plays an important role in staging lung cancer. It is essential to combine ^18F-FDG SPECT with enhanced CT to evaluate staging of lung cancer.
出处
《北京医学》
CAS
2008年第10期596-599,共4页
Beijing Medical Journal
