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目的 探讨正电子发射体层成像 (PET)在肺癌诊治中的作用。方法 收集 1998年 9月1日至 2 0 0 0年 3月 1日期间就诊的肺癌或拟诊为肺癌的患者 ,均行PET及胸腹部CT、骨显像检查。结果 共收集 88例患者 ,其中肺癌患者 6 8例 (77 3% ) ,良性疾病者 2 0例 (2 2 7% )。CT与PET共发现12 5个肺内病灶 ,其中恶性病灶 80个 (6 4 0 % ) ,良性病灶 45个 (36 0 % ) ,恶性病灶的标准摄取比(SUR)值明显高于良性病灶。PET诊断肺癌的敏感性、特异性与病灶是否经过放化疗无关 ,但与病灶大小相关。对肺内病灶PET所见及SUR值诊断的特异性及准确性均高于CT ,其中PET诊断的敏感性、特异性和准确性分别为 95 0 %、95 6 %及 95 2 % ;SUR值诊断分别为 6 5 0 %、91 1%及 74 4%。SUR值诊断直径≥ 1 5cm的肺内病灶的准确性高于直径 <1 5cm的病灶。在诊断肺癌肺门淋巴结、纵隔淋巴结、远处淋巴结转移中 ,PET敏感性及准确性均显著高于CT。SUR值与细胞分化程度无关 ;小细胞肺癌经过放化疗后SUR值显著下降。结论 PET在判断肺内病灶的良恶性程度上有优势 ,且能准确判断肺癌淋巴结转移情况。对直径 <1 5cm的病灶及放化疗后的病灶 ,PET诊断的准确性高
Objective To explore the role of positron emission tomography (PET) in the diagnosis and treatment of lung cancer. METHODS: Patients with lung cancer or suspected lung cancer who were diagnosed between September 1, 1998 and March 1, 2000 were recruited for PET and chest and abdomen CT and bone scans. Results A total of 88 patients were collected, including 68 (77.7%) patients with lung cancer and 20 patients (22.7%) with benign disease. A total of 125 pulmonary lesions were found in CT and PET, of which 80 (60%) were malignant lesions and 45 (36.0%) were benign lesions. The standard uptake ratio (SUR) values of malignant lesions were significantly higher than those of benign lesions. The sensitivity and specificity of PET in the diagnosis of lung cancer have nothing to do with radiotherapy and chemotherapy, but it is related to the size of the lesion. The specificity and accuracy of PET findings and SUR values in lung lesions were higher than that of CT. The sensitivity, specificity, and accuracy of PET diagnosis were 95%, 95%, and 95 2%, respectively; SUR values. The diagnosis was 65%, 91% and 744% respectively. The accuracy of SUR values for diagnosing intra-pulmonary lesions with diameter ≥ 15 cm was higher than lesions with diameter <1 5 cm. In the diagnosis of pulmonary hilar lymph nodes, mediastinal lymph nodes, distant lymph node metastasis, PET sensitivity and accuracy were significantly higher than CT. The SUR value was not related to the degree of cell differentiation; the SUR value of small cell lung cancer after radiotherapy and chemotherapy was significantly decreased. Conclusions PET has advantages in judging the degree of benign and malignant lesions in lung, and can accurately determine lymph node metastasis in lung cancer. High accuracy of PET diagnosis for lesions < 1 5cm in diameter and after radiotherapy and chemotherapy