Li Xiang-dong, Yin Ji-lin, Liu Wei-kun, Ouyang Xi, Zhou Zheng, Qiao Gui-bin, Zhang Ji-ren
Oncology Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2010 Mar;30(3):506-8.
To investigate the value of positron emission tomographic-computed tomographic scanning (PET/CT) in the diagnosis of mediastinal lymph node metastasis in patients with non-small cell lung cancer and the application of PET/CT in the clinical staging of NSCLC.
A hundred and fifty-eight patients with NSCLC undergoing surgical resection and mediastinoscopy received preoperative examinations with PET/CT. All the patients underwent mediastinal lymph node dissection or sampling, and the pathological results were compared with the imaging findings. The diagnostic sensitivity, specificity, positive and negative predictive values, and accuracy of CT and PET/CT were compared.
Final histology was available for 937 lymph node samples (N1, N2, and N3) from 158 patients during mediastinoscopy or surgical resection. The sensitivity, specificity, and positive and negative predictive values of CT for identifying mediastinal lymph node involvement were 51.0%, 76.1%, 49.0%, and 77.6%, respectively, with an diagnostic accuracy of 68.4%. The sensitivity, specificity, and positive and negative predictive values of PET/CT were 83.7%, 89.0%, 77.4%, and 92.4%, respectively, with a diagnostic accuracy of 87.3%.
Mediastinoscopy is essential for patients with positive findings of mediastinal lymph node involvement by PET/CT, but might not be necessary in negative patients.
探讨正电子发射断层扫描-计算机断层扫描（PET/CT）在非小细胞肺癌患者纵隔淋巴结转移诊断中的价值以及PET/CT在非小细胞肺癌临床分期中的应用。
158例接受手术切除及纵隔镜检查的非小细胞肺癌患者术前行PET/CT检查。所有患者均行纵隔淋巴结清扫或取样，并将病理结果与影像学检查结果进行比较。比较CT和PET/CT的诊断敏感性、特异性、阳性和阴性预测值以及准确性。
在纵隔镜检查或手术切除过程中，158例患者的937个淋巴结样本（N1、N2和N3）获得了最终组织学结果。CT识别纵隔淋巴结受累的敏感性、特异性、阳性和阴性预测值分别为51.0%、76.1%、49.0%和77.6%，诊断准确性为68.4%。PET/CT的敏感性、特异性、阳性和阴性预测值分别为83.7%、89.0%、77.4%和92.4%，诊断准确性为87.3%。
对于PET/CT检查显示纵隔淋巴结受累阳性的患者，纵隔镜检查至关重要，但对于阴性患者可能并非必要。
