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目的探讨18F-FDG PET-CT确定非小细胞肺癌(NSCLC)患者区域淋巴结放疗靶区的价值。方法回顾性分析58例经根治性手术治疗的NSCLC患者,术前同期行PET-CT和CT检查。经盲法阅片后,由肿瘤放射治疗医师结合影像诊断结果分别在PET-CT和CT图像上勾画靶区,并与病理诊断结果进行对照。结果CT诊断纵隔淋巴结转移的灵敏度、特异度、准确率、阳性预测值及阴性预测值分别为56.0%、54.2%、54.8%、38.9%和70.3%,PET-CT分别为88.0%、85.4%、86.3%、75.9%和93.2%,两者差异均有统计学意义(P<0.05)。CT和PET-CT对诊断肺门区域淋巴结的差异无统计学意义。18F-FDG PET参与靶区勾画后,46.5%的患者淋巴结靶区改变,其靶区完全包含转移性淋巴结的准确率为75.9%,与单纯CT(48.3%)的准确率比较,差异有统计学意义(P<0.05)。结论18F-FDG PET-CT能更准确地估计NSCLC患者区域淋巴结转移的范围,从而指导放疗靶区的勾画。
Objective To investigate the value of 18F-FDG PET-CT for regional lymph node radiotherapy in patients with non-small cell lung cancer (NSCLC). Methods A retrospective analysis of 58 cases of radical surgery of NSCLC patients, preoperative PET-CT and CT examination. After blind reading, the tumor radiotherapy physicians combined with the diagnostic results of the images to sketch the target area on the PET-CT and CT images, respectively, and compared with the pathological diagnosis results. Results The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CT in the diagnosis of mediastinal lymph node metastasis were 56.0%, 54.2%, 54.8%, 38.9% and 70.3%, respectively. The PET-CT was 88.0% and 85.4% 86.3%, 75.9% and 93.2%, respectively, with statistical significance (P <0.05). CT and PET-CT in the diagnosis of hilar lymph nodes were no significant difference. 18F-FDG PET target area mapping, 46.5% of patients changed the target area of lymph nodes, the target area completely contains metastatic lymph nodes accuracy was 75.9%, compared with pure CT (48.3%) accuracy, the difference was statistically significant Significance (P <0.05). Conclusion 18F-FDG PET-CT can more accurately estimate the range of regional lymph node metastasis in patients with NSCLC, and thus guide the outline of radiotherapy target area.