Fischer B M, Mortensen J, Langer S W, Loft A, Berthelsen A K, Petersen B I, Daugaard G, Lassen U, Hansen H H
Department of Nuclear Medicine and PET, Copenhagen University Hospital, Copenhagen, Denmark.
Ann Oncol. 2007 Feb;18(2):338-45. doi: 10.1093/annonc/mdl374. Epub 2006 Oct 23.
Small-cell lung cancer (SCLC) accounts for 15%-20% of all lung cancer cases. Accurate and fast staging is mandatory when choosing treatment, but current staging procedures are time consuming and lack sensitivity.
A prospective study was designed to examine the role of combined positron emission tomography/computed tomography (PET/CT) compared with standard staging (CT, bone scintigraphy and immunocytochemical assessment of bone marrow biopsy) of patients with SCLC. Thirty-four consecutive patients were included. Twenty-nine patients received initial PET/CT.
PET/CT caused change of stage in 5/29 (17%). Excluding patients with unconfirmed findings or pleural effusion, the sensitivity for accurate staging of patients with extensive disease was the following: for standard staging 79%, PET 93% and PET/CT 93%. Specificity was 100%, 83% and 100%, respectively.
The results from this first study on PET/CT in SCLC indicates that PET/CT can simplify and perhaps even improve the accuracy of the current staging procedure in SCLC. A larger clinical trial, preferably with consequent histological confirmation in case of discordance, however, is warranted.
小细胞肺癌（SCLC）占所有肺癌病例的15% - 20%。选择治疗方案时，准确快速的分期必不可少，但目前的分期程序耗时且缺乏敏感性。
设计了一项前瞻性研究，以检验正电子发射断层扫描/计算机断层扫描（PET/CT）联合检查与小细胞肺癌患者标准分期（CT、骨闪烁显像及骨髓活检的免疫细胞化学评估）相比的作用。纳入了34例连续患者。29例患者接受了初始PET/CT检查。
PET/CT使29例中的5例（17%）分期发生改变。排除检查结果未得到证实或有胸腔积液的患者后，广泛期疾病患者准确分期的敏感性如下：标准分期为79%，PET为93%，PET/CT为93%。特异性分别为100%、83%和100%。
这项关于PET/CT用于小细胞肺癌的首次研究结果表明，PET/CT可以简化甚至可能提高目前小细胞肺癌分期程序的准确性。然而，需要进行一项更大规模的临床试验，最好在出现不一致情况时进行后续组织学确认。
