18F-FDG PET/CT对非小细胞肺癌治疗后纵隔淋巴结转移再分期的价值

Value of 18F-FDG PET/CT for restaging metastasis of mediastinal lymph nodes in patients with non-small cell lung cancer

  • 摘要: 目的 应用18F-FDGPET/CT为手术或放化疗后非小细胞肺癌(NSCLC)患者进行再分期,以评价18F-FDGPET/CT在诊断纵隔淋巴结转移的价值。方法 本组受检者51例(男41例,女10例),年龄34-90岁(平均61.86±12.81岁)。鳞癌29例,腺癌20例,腺鳞癌2例。根据文献中接收器工作特性分析确定良恶性结节阈值截点SUV值>3.5为阳性淋巴结。结果 51例患者中45例检出纵隔淋巴结,SUV值>3.5的阳性淋巴结共有63%(79/125),SUV值>3.5且小于1cm结节35%(28/79),SUV值>3.5且大于1cm结节65%(51/79)。肺腺癌20例中阳性淋巴结58%(46/79),鳞癌29例中阳性淋巴结41%(32/79),腺鳞癌2例中阳性淋巴结1%(1/79)。肺腺癌和鳞癌患者小于1cm和大于1cm的阳性淋巴结数量的差异有统计学意义(χ2=18.25,P<0.05)。结论 18F-FDGPET/CT对NSCLC治疗后纵隔淋巴结转移的再分期有较大价值。

     

    Abstract: Objective To evaluate the value of 18 fluorodeoxyglucose(FDG) positron emission tomography and computed tomography(PET/CT) for restaging metastasis of mediastinal lymph nodes in patients with non-small cell lung cancer(NSCLC) after treatment. Methods Of the 51 NSCLC patients(41 men and 10 women) at a mean age of 61 years(range 34-90 years) included in this study,29 had squamous carcinoma,20 had adenocarcinoma,and 2 had adenosquamous carcinoma.If the SUV threshold cutoff was >3.5 according to prior receiver operating characteristic analysis,the lymph nodes were defined as positive. Results Mediastinal lymph nodes were detected in 45 of the 51 patients.The SUV value was >3.5 in 63%(79/125) lymph nodes,in 35%(28/79) lymph nodes less than 1cm in diameter,and in 65%(51/79) lymph nodes greater than 1cm in diameter,respectively.The positive rate of lymph nodes was 58%(46/79),41%(32/79),and 1%(1/79)in 20 patients with lung adenocarcinoma,in 29 patients with squamous carcinoma,and in 2 patients with adenosquamous carcinoma,respectively.No difference was found in the number of lymph nodes less or greater than 1cm in diameter between patients with lung adenocarcinoma and those with squamous carcinoma(χ2=18.25,P<0.05). Conclusion 18F-FDG PET/CT has a high predictive value for restaging metastasis of mediastinal lymph nodes in NSCL patients.

     

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