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目的探讨正电子发射计算机断层显像(PET/CT)在诊断卵巢恶性肿瘤淋巴转移中的临床价值。方法选取2011年1月至2014年12月期间收治的104例卵巢恶性肿瘤患者为研究对象,采用PET/CT检查对所有患者腹膜后淋巴结、腹主动脉旁淋巴结、盆腔淋巴结转移及浅表淋巴结转移的位置和状况进行评价。初次治疗患者行卵巢癌肿瘤细胞减灭术联合腹膜后淋巴结清扫术,复发患者行区域和病灶淋巴结清扫术。以术后淋巴结病理检查结果为标准,计算PET/CT对卵巢恶性肿瘤淋巴结转移诊断的特异性、敏感性、准确性、阴性预测值和阳性预测值。结果以术后病理检查结果为标准,PET/CT显像诊断卵巢恶性肿瘤患者盆腔淋巴结转移的敏感性90.91%、特异性95.12%、准确性94.23%、阳性预测值83.33%和阴性预测值97.50%;诊断腹主动脉旁淋巴结转移的敏感性96.30%、特异性100.00%、准确性98.08%、阳性预测值100.00%和阴性预测值96.15%;诊断腹膜后淋巴结转移的敏感性96.30%、特异性92.00%、准确性94.23%、阳性预测值92.86%和阴性预测值95.83%。PET/CT显示体检阴性的左锁骨上淋巴结转移4例,腋窝淋巴结转移4例,淋巴结大小1.0~1.2 cm,均经术后病理证实。结论PET/CT检查是术前判断卵巢恶性肿瘤是否发生淋巴结转移的重要手段,对淋巴结转移的诊断有较高的临床价值,对卵巢恶性肿瘤的治疗有重要指导意义。
Objective To investigate the clinical value of positron emission tomography (PET / CT) in the diagnosis of lymphatic metastasis of ovarian cancer. Methods A total of 104 patients with ovarian cancer who were admitted to our hospital from January 2011 to December 2014 were enrolled in this study. All patients were retrospectively studied for retroperitoneal lymph node, para-aortic lymph node, pelvic lymph node metastasis and superficial lymph node metastasis The location and status of the evaluation. Initial treatment of patients with ovarian cancer cytoreductive surgery combined with retroperitoneal lymph node dissection, recurrent patients with regional lymph node dissection and lesions. The specificity, sensitivity, accuracy, negative predictive value and positive predictive value of PET / CT in the diagnosis of lymph node metastasis of ovarian cancer were calculated by the postoperative pathological results of lymph nodes. Results The postoperative pathological examination showed that the sensitivity and specificity of PET / CT in diagnosis of pelvic lymph node metastasis were 90.91%, 95.12%, 94.23%, 83.33% and 97.50%, respectively. ; Sensitivity of 96.30%, specificity of 100.00%, accuracy of 98.08%, positive predictive value of 100.00% and negative predictive value of 96.15% for diagnosis of para-aortic lymph node metastasis; sensitivity of diagnosis of retroperitoneal lymph node metastasis was 96.30%, specificity of 92.00 %, Accuracy 94.23%, positive predictive value 92.86% and negative predictive value 95.83%. PET / CT showed 4 cases of negative left supraclavicular lymph node metastasis, 4 cases of axillary lymph node metastasis and 1.0 ~ 1.2 cm of lymph node, which were confirmed by pathology. Conclusion PET / CT examination is an important method to determine whether lymph node metastasis occurs in ovarian cancer preoperatively. It has high clinical value in the diagnosis of lymph node metastasis and has important guiding significance for the treatment of ovarian cancer.