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目的比较18F-FDG PET/CT与增强CT在肺癌淋巴结术前诊断及分期中的价值。方法以病理结果为金标准,比较82例肺癌患者术前PET/CT及增强CT检查者对区域淋巴结诊断及分期的效能。结果82例患者共切除区域淋巴结564枚,其中78枚(13.8%)证实为转移。PET/CT诊断区域淋巴结转移的灵敏度、特异度、准确度、阳性预测值及阴性预测值均显著高于增强CT,P均<0.05。PET/CT与增强CT对区域淋巴结分期总的准确性分别为[87.8%(72/82)及70.7%(50/82)],P<0.05;对区域淋巴结N0、N1、N2期诊断的准确性分别为[89.3%(25/28)、83.3%(20/24)、90.0%(27/30)]vs[85.7%(24/28)、50.0%(12/24)、73.3%(22/30)]。结论 PET/CT诊断区域淋巴结转移的效能高于增强CT,但是仍存在一定的假阳性及假阴性。临床工作中需要结合患者的临床资料,进一步提高诊断及分期的准确性。
Objective To compare the value of 18F-FDG PET / CT and enhanced CT in the preoperative diagnosis and staging of lung cancer lymph nodes. Methods The pathological results were taken as the gold standard to compare the efficacy of preoperative PET / CT and enhanced CT in diagnosing and staging lymph node in 82 patients with lung cancer. Results A total of 564 regional lymph nodes were resected in 82 patients, of which 78 (13.8%) were confirmed as metastasis. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PET / CT in diagnosing regional lymph node metastasis were significantly higher than those in enhanced CT, P <0.05. The overall accuracy of regional lymph node staging by PET / CT and contrast-enhanced CT was 87.8% (72/82) and 70.7% (50/82), respectively (P <0.05). The accuracy of diagnosis of regional lymph nodes in N0, N1 and N2 (89.3% (25/28), 83.3% (20/24), 90.0% (27/30)] vs 85.7% (24/28), 50.0% (12/24), 73.3% (22) / 30)]. Conclusions PET / CT is more effective in diagnosing regional lymph node metastasis than enhanced CT, but there are still some false positives and false negatives. Clinical work needs to be combined with the clinical data of patients to further improve the accuracy of diagnosis and staging.