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目的探讨18氟-脱氧葡萄糖正电子发射计算机断层显像/计算机体层成像(18F-FDG PET/CT)对非小细胞肺癌淋巴结转移的诊断价值。方法回顾性分析2012年3月至2015年3月我院167例患者的临床资料,所有病例术前10 d内行18FFDG PET/CT及胸部增强CT检查并经术后病理诊断为非小细胞肺癌。根据PET/CT、增强CT及术后病理结果,计算PET/CT、增强CT判断淋巴结转移的灵敏度、特异性、准确度、阳性预测值、阴性预测值及约登指数并相互比较。结果 167例患者中共清扫出731组淋巴结,以术后病理结果为依据,PET/CT诊断出真阳性、假阳性、假阴性、真阴性淋巴结各有143组、26组、61组、501组,进而得出其灵敏度、特异度、准确度、阳性预测值、阴性预测值、约登指数分别为70.10%、95.07%、88.10%、84.62%、89.15%、0.65,增强CT分别为54.19%、92.23%、81.67%、72.85%、83.97%、0.4,二者差异有统计学意义(P<0.05)。结论 PET/CT对非小细胞肺癌淋巴结转移的诊断效能高于增强CT,可以更好地为肺癌术前诊断、分期和后续治疗方式的选择提供依据。
Objective To investigate the diagnostic value of 18F-FDG PET / CT in diagnosis of lymph node metastasis of non-small cell lung cancer by 18 F-FDG positron emission tomography / computed tomography. Methods The clinical data of 167 patients in our hospital from March 2012 to March 2015 were retrospectively analyzed. All cases were examined by 18 FFDG PET / CT and chest enhanced CT within 10 days before operation and were diagnosed as non-small cell lung cancer by postoperative pathology. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Youden index of PET / CT and enhanced CT in predicting lymph node metastasis were calculated and compared with PET / CT, CT and postoperative pathological results. Results A total of 731 lymph nodes were dissected out from 167 patients. According to the postoperative pathological findings, PET / CT diagnosis showed true positive, false positive, false negative and true negative lymph nodes in 143, 26, 61, 501, The results showed that the sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Youden index were 70.10%, 95.07%, 88.10%, 84.62%, 89.15%, 0.65 respectively, and the enhanced CT were 54.19%, 92.23 %, 81.67%, 72.85%, 83.97% and 0.4, respectively. The difference between the two groups was statistically significant (P <0.05). Conclusion The diagnostic efficiency of PET / CT in lymph node metastasis of non-small cell lung cancer is higher than that of enhanced CT, which can provide the basis for the preoperative diagnosis, staging and follow-up treatment of lung cancer.