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目的通过18F-FDG SPET/CT扫描诊断食管癌淋巴结转移与术后病理金标准比较,评价18F-FDG SPET/CT诊断的准确性,为临床应用提供理论依据。方法选择2007年1月～2010年6月首程治疗行颈、胸、腹三野淋巴结清扫的胸段食管癌根治术40例患者,术前1周内行18F-FDG SPET/CT检查,将18F-FDG SPET/CT诊断食管淋巴结转移与术后病理诊断进行对比研究。结果全组共清除淋巴结1216枚,平均每例清除淋巴结30.4枚(15～55枚),淋巴结转移率67.5%。SPET/CT诊断食管癌总淋巴结转移的敏感性、特异性及准确性分别为44.4%、84.6%和57.5%。但进一步分析SPET/CT诊断对颈部、上纵隔、下纵隔及腹部区域淋巴结转移的准确性较低,分别为35.0%、50.0%、32.5%和27.5%。其中转移淋巴结短径<0.8cm、0.8～1.2cm和>1.2cm的准确性分别为0.0%、43.8%和84.6%。结论 18F-FDG SPET/CT对食管癌淋巴结转移诊断有较高的特异性,但敏感性及准确性较低;对转移淋巴结短径>1.2cm有较高的准确性。
OBJECTIVE: To evaluate the diagnostic accuracy of 18F-FDG SPET / CT by 18F-FDG SPET / CT scan in diagnosis of esophageal cancer lymph node metastasis and postoperative pathological gold standard, and to provide a theoretical basis for clinical application. Methods Forty patients with thoracic esophagectomy who underwent neck, thoracic and abdominal three-node lymphadenectomy from January 2007 to June 2010 were enrolled in this study. 18F-FDG SPET / CT examination was performed within 1 week before operation. 18F- FDG SPET / CT diagnosis of esophageal lymph node metastasis and postoperative pathological diagnosis were compared. Results A total of 1216 lymph nodes were removed in this study. The average number of lymph nodes removed was 30.4 (15 ~ 55) and the rate of lymph node metastasis was 67.5%. The sensitivity, specificity and accuracy of SPET / CT in the diagnosis of total lymph node metastasis of esophageal cancer were 44.4%, 84.6% and 57.5% respectively. However, the accuracy of SPET / CT in the diagnosis of lymph node metastasis in the neck, the mediastinum, the mediastinum and the abdominal region was lower, which were 35.0%, 50.0%, 32.5% and 27.5% respectively. The accuracy of metastasis lymph node short diameter <0.8cm, 0.8 ~ 1.2cm and> 1.2cm were 0.0%, 43.8% and 84.6% respectively. Conclusion 18F-FDG SPET / CT has high specificity for the diagnosis of lymph node metastasis of esophageal cancer, but its sensitivity and accuracy are low. The accuracy of 18F-FDG SPET / CT for the diagnosis of metastatic lymph node metastasis is high.