Abstract:

Objective　To explore the application value of positron emission tomography - computed tomography (PET-CT) in preoperative assessment of regional lymph node metastasis in non-small cell lung cancer. Methods　A total of 60 cases of non-small cell lung cancer in Department of Cardiothoracic Surgery, Jieyang People's Hospital from January to December 2020 were selected as the research objects, including 24 males and 36 females, aged (58.98±7.97) years. All cases completed fludeoxyglucose [¹⁸F] (¹⁸F-FDG) PET-CT and enhanced CT scanning before surgery. Hilar mediastinal lymph node metastasis was recorded in detail. With the postoperative pathological diagnosis as the gold standard, the accuracies, sensitivities, specificities, and positive and negative predictive values of the two methods were calculated and compared. Paired χ² test was used. Results　According to the pathological results, in the 60 cases, there were 22 cases of regional lymph node metastasis and 38 cases without lymph node metastasis. PET-CT correctly diagnosed 52 cases, including 20 cases of hilar mediastinal lymph node metastasis and 32 cases without lymph node metastasis, 6 false positives, and 2 false negatives; the accuracy, sensitivity, specificity, and positive and negative predictive values of PET-CT were 0.87, 0.91, 0.84, 0.77, and 0.94. Enhanced CT scanning correctly diagnosed 38 cases, including 14 cases with hilar mediastinal lymph node metastasis and 24 cases without lymph node metastasis, 14 false positives, and 8 false negatives; the accuracy, sensitivity, specificity, and positive and negative predictive values of enhanced CT scanning were 0.63, 0.64, 0.63, 0.50, and 0.75. The accuracies, sensitivities, and specificities of the two inspection methods were statistically significantly different (all P<0.05). Conclusion　The diagnostic efficiency of PET-CT in preoperative assessment of regional lymph node metastasis in non-small cell lung cancer is better than that of enhanced CT scanning, and is worthy of clinical application.

Key words:

Non-small cell lung cancer, Lymph node metastasis, PET-CT, Preoperative assessment

摘要：

目的　探讨正电子发射计算机断层显像（PET-CT）在非小细胞肺癌术前区域淋巴结转移评估中的应用价值。方法　收集2020年1月至12月揭阳市人民医院胸心外科的非小细胞肺癌患者60例为研究对象，其中男性24例，女性36例，年龄（58.98±7.97）岁。术前行¹⁸氟脱氧葡萄糖（¹⁸F-FDG）PET-CT和增强CT扫描，详细记录肺门纵隔淋巴结转移情况，以术后病理诊断作为金标准，计算并对比两者的准确度、灵敏度、特异度、阳性预测值和阴性预测值。采用配对χ²检验。结果　根据术后病理诊断结果，在60例非小细胞肺癌患者中，出现区域淋巴结转移有22例，未出现淋巴结转移有38例。PET-CT正确诊断52例，其中确诊肺门纵隔淋巴结转移20例，未出现淋巴结转移32例，假阳性6例，假阴性2例，其准确度、灵敏度、特异度、阳性预测值和阴性预测值分别为0.87、0.91、0.84、0.77、0.94。增强CT扫描正确诊断38例，其中确诊肺门纵隔淋巴结转移14例，未出现淋巴结转移24例，假阳性14例，假阴性8例，其准确度、灵敏度、特异度、阳性预测值和阴性预测值分别为0.63、0.64、0.63、0.50、0.75。两种检查方法的准确度、灵敏度、特异度差异均有统计学意义（均P<0.05）。结论　PET-CT在非小细胞肺癌术前区域淋巴结转移评估中的诊断效能优于增强CT扫描，值得推广应用。

关键词:

非小细胞肺癌, 淋巴结转移, PET-CT, 术前评估