使用计算机断层扫描和正电子发射断层扫描对非小细胞肺癌进行纵隔分期

Mediastinal staging of non-small cell lung carcinoma using computed and positron-emission tomography.

作者信息

Kiernan Paul D, Sheridan Michael J, Lamberti James, Dicicco Barry, Wigton Roger, Hetrick Vivian, Vaughan Betty, Graling Paula

机构信息

Department of Medicine, Inova Fairfax Hospital, VA, USA.

出版信息

South Med J. 2002 Oct;95(10):1168-72.

PMID:12425503

Abstract

BACKGROUND

We evaluated the accuracy of computed tomography (CT) and positron-emission tomography (PET) in the mediastinal staging of non-small cell lung cancer.

METHODS

Between May 14, 1999, and November 28, 2000, computerized tomography (CT) and positron-emission tomography (PET) were used to clinically stage 94 consecutive patients with non-small cell carcinoma of the lung (NSCCL). All patients underwent subsequent surgical staging with mediastinoscopy, anterior mediastinotomy, and/or thoracotomy with mediastinal lymphadenectomy.

RESULTS

Overall accuracy was the same for both procedures. False-negative results occurred 3 times more often with CT; false-positive results occurred twice as often with PET. Sensitivity and specificity were 64% and 94%, respectively, for CT, versus 88% and 86%, respectively, for PET. Positive and negative predictive values were 80% and 88%, respectively, for CT, versus 71% and 95%, respectively, for PET.

CONCLUSION

In addition to routine use of CT, PET seems to achieve high negative predictive value in the evaluation of mediastinal disease; PET seems particularly helpful in assessing absence of tumor in bulky nodes after neoadjuvant chemotherapy and/or radiotherapy.

摘要

背景

我们评估了计算机断层扫描（CT）和正电子发射断层扫描（PET）在非小细胞肺癌纵隔分期中的准确性。

方法

在1999年5月14日至2000年11月28日期间，使用计算机断层扫描（CT）和正电子发射断层扫描（PET）对94例连续的非小细胞肺癌（NSCCL）患者进行临床分期。所有患者随后均接受了纵隔镜检查、前纵隔切开术和/或开胸纵隔淋巴结清扫术的手术分期。

结果

两种检查方法的总体准确性相同。CT的假阴性结果出现频率是PET的3倍；PET的假阳性结果出现频率是CT的两倍。CT的敏感性和特异性分别为64%和94%，而PET的敏感性和特异性分别为88%和86%。CT的阳性预测值和阴性预测值分别为80%和88%，而PET的阳性预测值和阴性预测值分别为71%和95%。