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目的探讨18氟-脱氧葡萄糖(18F-FDG)双探头符合线路对非小细胞肺癌胸内淋巴结转移的诊断价值,并分析其假阳性、假阴性诊断的原因。方法回顾性分析2010年12月-2012年6月非小细胞肺癌患者161例的临床资料,其中腺癌122例,鳞癌23例,其他类型16例。分析患者术前18F-FDG双探头符合线路显像对肺门、纵膈淋巴结的诊断结果(其中阳性53例,阴性108例),以术后病理诊断为金标准,评价其诊断价值。分析9例假阳性、26例假阴性诊断患者的吸烟史、慢性支气管炎肺气肿、肺结核病史、局限性肺炎、肿瘤标志物、淋巴结短径、肿瘤原发灶T/N比值、外周血白细胞等指标。结果 18F-FDG双探头符合线路单光子发射计算机断层成像(SPECT)诊断非小细胞肺癌淋巴结转移的灵敏度、特异性、准确性、阳性预测值、阴性预测值分别是62.9%、90.1%、78.3%、83%、75.9%。假阳性组患者慢支炎肺气肿、局限性肺炎者高于真阳性组。假阴性组的淋巴结短径、原发灶T/N比值小于真阳性组。结论 18F-FDG双探头符合线路SPECT是术前诊断肺癌淋巴结转移的有效手段;假阳性淋巴结与慢支炎肺气肿、局限性肺炎有关;假阴性淋巴结与淋巴结短短径小、原发肿瘤摄取18F-FDG低有关。
Objective To investigate the diagnostic value of 18F-FDG dual-probe coincidence circuits in the diagnosis of intrathoracic lymph node metastasis of non-small cell lung cancer and to analyze the causes of its false positive and false negative diagnosis. Methods The clinical data of 161 patients with non-small cell lung cancer from December 2010 to June 2012 were retrospectively analyzed. Among them, 122 were adenocarcinoma, 23 were squamous cell carcinoma and 16 were other types. The diagnostic results of hilar and mediastinal lymph nodes (including 53 cases of positive and 108 cases of negative) of 18F-FDG dual-head coincidence imaging before operation were analyzed. The postoperative pathological diagnosis was the gold standard to evaluate the diagnostic value. The smoking history, chronic bronchitis emphysema, history of pulmonary tuberculosis, localized pneumonia, tumor markers, lymph node short diameter, T / N ratio of primary tumor and peripheral leukocyte were analyzed in 9 cases of false positive and 26 cases of false negative diagnosis. . Results The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 18F-FDG dual-probe coincidence SPECT in diagnosing non-small cell lung cancer lymph node metastasis were 62.9%, 90.1%, 78.3% , 83%, 75.9%. False positive patients with chronic bronchitis emphysema, localized pneumonia were higher than the true positive group. False negative group of lymph node short diameter, the primary tumor T / N ratio is less than the true positive group. Conclusions 18F-FDG dual-head coincidence SPECT is an effective method for the preoperative diagnosis of lymph node metastasis in lung cancer. False positive lymph nodes are associated with chronic bronchitis emphysema and localized pneumonia. The short diameter of false-negative lymph nodes and lymph nodes is small, 18F-FDG low.