正电子发射断层扫描对非小细胞肺癌进行分期：诊断价值、对患者管理的影响及成本效益

Staging non-small lung cancer with positron emission tomography: diagnostic value, impact on patient management, and cost-effectiveness.

作者信息

Nosotti Mario, Castellani Massimo, Longari Virgilio, Chella Barbara, Baisi Alessandro, Rosso Lorenzo, Santambrogio Luigi

机构信息

Department of Thoracic Surgery, IRCCS, Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy.

出版信息

Int Surg. 2008 Sep-Oct;93(5):278-83.

PMID:19943430

Abstract

The aim of this study was to compare two preoperative staging procedures of non-small cell lung cancer (NSCLC): one using positron emission tomography (PET) and one using conventional imaging studies. Accuracy, effects on patient management, and costs were calculated. Four hundred thirteen consecutive patients with NSCLC were prospectively examined with PET and conventional imaging studies. A simulation calculated the costs of the two strategies. The accuracy of PET for metastases was 97.5% versus 84% of conventional imaging (P < 0.001). The accuracy of PET for mediastinal staging was 97%, whereas that of computed tomography was 68% (P < 0.001). The expected number of unnecessary surgeries was 24 for the conventional strategy and 8 for the PET strategy (P= 0.007). The PET strategy was less expensive. This study shows that PET is an economical tool in NSCLC staging (even in the European economic environment), with high accuracy and important management aspects.

摘要

本研究的目的是比较非小细胞肺癌（NSCLC）的两种术前分期方法：一种使用正电子发射断层扫描（PET），另一种使用传统影像学检查。计算了准确性、对患者管理的影响及成本。对413例连续的NSCLC患者进行了PET和传统影像学检查的前瞻性研究。通过模拟计算了两种策略的成本。PET对转移灶的准确性为97.5%，而传统影像学检查为84%（P<0.001）。PET对纵隔分期的准确性为97%，而计算机断层扫描为68%（P<0.001）。传统策略预期的不必要手术例数为24例，PET策略为8例（P=0.007）。PET策略成本更低。本研究表明，PET在NSCLC分期中是一种经济的工具（即使在欧洲经济环境下），具有高准确性和重要的管理意义。