Farrell M A, McAdams H P, Herndon J E, Patz E F
Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA.
Radiology. 2000 Jun;215(3):886-90. doi: 10.1148/radiology.215.3.r00jn29886.
To determine the accuracy of 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in the evaluation of regional lymph nodes in patients with stage I non-small cell lung cancer (NSCLC).
Imaging and clinical findings obtained during 5 years in 84 patients (mean age, 66 years) were reviewed. Patients had thoracic computed tomographic findings of stage I NSCLC, an FDG PET study, and histopathologic proof of lung cancer. At the time of diagnosis, disease stage was assigned on the basis of FDG PET results and was compared with the histopathologic stage to determine the accuracy of PET.
When PET stage was compared with histopathologic stage, the disease in 72 (86%) patients was accurately staged with PET, understaged in two (2%), and overstaged in 10 (12%). The overall sensitivity, specificity, and positive and negative predictive values for PET of regional lymph nodal metastases were 82%, 86%, 47%, and 97%, respectively.
FDG PET enables accurate staging of regional lymph node disease in patients with stage I NSCLC. A negative PET scan in these patients suggests that mediastinoscopy is unnecessary and that these patients can proceed directly to thoracotomy.
确定2-[氟-18]氟-2-脱氧-D-葡萄糖（FDG）正电子发射断层扫描（PET）在评估I期非小细胞肺癌（NSCLC）患者区域淋巴结方面的准确性。
回顾了84例患者（平均年龄66岁）5年间获得的影像学和临床资料。患者有I期NSCLC的胸部计算机断层扫描结果、FDG PET检查以及肺癌的组织病理学证据。诊断时，根据FDG PET结果确定疾病分期，并与组织病理学分期进行比较，以确定PET的准确性。
将PET分期与组织病理学分期进行比较时，72例（86%）患者的疾病通过PET准确分期，2例（2%）分期过低，10例（12%）分期过高。PET对区域淋巴结转移的总体敏感性、特异性、阳性预测值和阴性预测值分别为82%、86%、47%和97%。
FDG PET能够准确对I期NSCLC患者的区域淋巴结疾病进行分期。这些患者PET扫描阴性表明无需进行纵隔镜检查，可直接进行开胸手术。
