Hu Ying-Ying, Liang Pei-Yan, Lin Xiao-Ping, Zhang Xu, Zhang Wei-Guang, Fan Wei
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, P. R. China.
Ai Zheng. 2009 Mar;28(3):312-7.
Lymph node metastases are commonly seen in malignant tumors of the head and neck. Detection of the primary tumors affects the quality of life and survival rates of these patients. This study was to evaluate the application of (18)F-FDG PET/CT in detecting primary tumors metastasizing to lymph nodes of the neck, and to assess the positive predictive value of (18)F-FDG PET/CT.
In total 93 patients with pathologically confirmed neck lymph node metastases from unknown primary tumors underwent (18)F-FDG PET/CT in Sun Yat-sen University Cancer Center between June 2005 to April 2008 were entered into this study. The primary tumors of patients were initially diagnosed according to different PET/CT standards as definite diagnosis, suspicious diagnosis and no signs of primary tumors. All diagnosis based on PET/CT images were verified by pathological exams or additional imaging tests.
Forty cases made definite diagnosis by PET/CT were all confirmed by pathological or clinical exams, with a positive predictive value of 100%. Of 28 cases made suspicious diagnosis, 16 were pathologically confirmed, with a positive predictive value of 57.1%. Two patients, who were suggested lymph node metastases in mediastinum without the sign of the primary tumor by PET/CT, were clinically verified as primary mediastinal lung cancer. The primary tumors of another two patients were not detected by PET/CT, but were found under endoscopy. The total detection rate of PET/CT for the primary tumor was 60.2% (56/93).
PET/CT is of important clinical value in detecting primary tumors metastasizing to lymph nodes of the neck.
淋巴结转移在头颈部恶性肿瘤中较为常见。原发肿瘤的检测影响这些患者的生活质量和生存率。本研究旨在评估18F-FDG PET/CT在检测转移至颈部淋巴结的原发肿瘤中的应用，并评估18F-FDG PET/CT的阳性预测值。
2005年6月至2008年4月期间，在中山大学肿瘤防治中心对93例经病理证实为颈部淋巴结转移但原发肿瘤不明的患者进行了18F-FDG PET/CT检查，并纳入本研究。根据不同的PET/CT标准，对患者的原发肿瘤初步诊断为明确诊断、可疑诊断和无原发肿瘤迹象。所有基于PET/CT图像的诊断均经病理检查或其他影像学检查验证。
PET/CT明确诊断的40例均经病理或临床检查证实，阳性预测值为100%。28例可疑诊断病例中，16例经病理证实，阳性预测值为57.1%。PET/CT提示纵隔淋巴结转移但无原发肿瘤迹象的2例患者，临床证实为原发性纵隔肺癌。另外2例患者的原发肿瘤PET/CT未检测到，但在内镜检查中发现。PET/CT对原发肿瘤的总检出率为60.2%（56/93）。
PET/CT在检测转移至颈部淋巴结的原发肿瘤方面具有重要的临床价值。
