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目的了解正电子发射体层成像(PET)在肺癌诊断和分期中的价值。方法收集1998年9月至2003年4月间行PET和CT检查,且诊断明确的肺部疾病患者的临床资料,对PET和CT检查结果与病理检查结果进行对比分析。结果在此期间共收集104例患者,其中肺癌64例(60%),肺部良性疾病40例(40%)。肺癌患者PET的标准摄取比值(SUV值)中位值为4.5(1.2～11.7),明显高于良性患者的1.0(0～7.7);且肺癌患者的SUV值与肺癌组织学类型、分化程度、临床分期和病灶大小均无关(P>0.05)。PET诊断肺癌的敏感性、特异性和准确性分别为88%、85%和87%;CT的敏感性、特异性和准确性分别为73%、28%、57%,PET的特异性和准确性显著高于CT(P<0.05)。对于胸腔淋巴结转移诊断的敏感性、特异性和准确性CT:N1期分别为33%、73%、59%,N2期分别为80%、79%、79%,N3期特异性及准确性均为97%;PET:N1期分别为33%、82%、65%,N2期分别为60%、83%、85%,N3期特异性及准确性均为85%;两者差异无统计学意义(P>0.05)。结论PET在鉴别肺内病灶良恶性质上有优势,对胸腔内淋巴结转移的诊断要结合CT结果综合判断。
Objective To understand the value of positron emission tomography (PET) in the diagnosis and staging of lung cancer. Methods The clinical data of patients with lung disease diagnosed by PET and CT from September 1998 to April 2003 were collected. The results of PET and CT were compared with the results of pathological examination. Results A total of 104 patients were collected during this period, of which 64 (60%) had lung cancer and 40 (40%) had benign lung disease. The median SUV of patients with lung cancer was 4.5 (1.2 ~ 11.7), which was significantly higher than that of benign patients (1.0-7.0). The SUV of patients with lung cancer was significantly correlated with histological type, differentiation, Clinical stage and size of the lesions had no correlation (P> 0.05). The sensitivity, specificity and accuracy of PET in the diagnosis of lung cancer were 88%, 85% and 87% respectively. The sensitivity, specificity and accuracy of CT were 73%, 28%, 57% respectively. The specificity and accuracy of PET Sex was significantly higher than CT (P <0.05). The sensitivity, specificity and accuracy of CT: N1 stage were 33%, 73%, 59% respectively for the diagnosis of thoracic lymph node metastasis and 80%, 79%, 79% for N2 stage respectively Was 97%; PET: N1 stage were 33%, 82%, 65%, N2 were 60%, 83%, 85%, N3 specificity and accuracy were 85%; no significant difference between the two Significance (P> 0.05). Conclusion PET has the advantage in differentiating benign and malignant lesions in the lung. The diagnosis of intrathoracic lymph node metastasis should be combined with the CT findings.