论文部分内容阅读
目的:分析18F-PET/CT在诊断非小细胞肺癌(NSCLC)前哨淋巴结(SLN)和非前哨淋巴结(Non-SLN)转移情况的应用价值及其临床意义。方法:采用前瞻性研究分析,随机选择可手术切除的周围性NSCLC患者60例,患者手术前全部行18F-PET/CT检查判断淋巴结转移情况。18F-PET/CT判断淋巴结转移标准为SUV≥2.5,术中肺癌SLN应用亲脂的异舒泛蓝染料法进行识别,将所探测的淋巴结分别切除后行术中快速病理检查,PET/CT和SLN最终以病理诊断为标准。结果:60例NSCLC患者中有37例成功识别出蓝染SLN,SLN检出率61.7%(37/60)。成功识别SLN的37例患者中,术前经18F-PET/CT诊断为N0患者共18例,清除SLN 31枚,转移8枚;清除Non-SLN 195枚,转移17枚,SLN的转移度明显高于Non-SLN(20.5%vs 8.0%,P<0.05),转移率差异无统计学意义(16.7%vs 7.2%,P>0.05)。结论:18F-PET/CT能较准确的诊断SLN转移,但存在一定的漏诊率,将PET/CT和肺癌前哨淋巴结结合,有助于区域淋巴结转移的准确诊断。
Objective: To analyze the clinical value of 18F-PET / CT in the diagnosis of non-SLN and non-SLN metastasis in non-small cell lung cancer (NSCLC). Methods: A prospective study of 60 patients with surgically resected peripheral NSCLC was performed. All patients underwent 18F-PET / CT before operation to determine the lymph node metastasis. 18F-PET / CT criteria for lymph node metastasis SUV ≥ 2.5, intraoperative lung SLN lipophilic isoflavone blue dye method to identify, the detected lymph nodes were removed after rapid intraoperative pathological examination, PET / CT and SLN eventually pathological diagnosis as the standard. Results: 37 of 60 patients with NSCLC successfully identified blue-stained SLN. The detection rate of SLN was 61.7% (37/60). Of the 37 patients with successfully identified SLNs, 18 were diagnosed as N0 by preoperative 18F-PET / CT, 31 of SLN were removed and 8 of them were transferred; 195 of Non-SLN were removed and 17 of them were transferred, and the degree of SLN metastasis was significantly There was no significant difference in metastasis rate between non-SLN and non-SLN (20.5% vs 8.0%, P <0.05) (16.7% vs 7.2%, P> 0.05). Conclusion: 18F-PET / CT can diagnose SLN metastasis more accurately, but there is a certain misdiagnosis rate. PET / CT combined with sentinel lymph node of lung cancer is helpful for the accurate diagnosis of regional lymph node metastasis.