Department of Surgery, Chutung Veterans Hospital, Chutung, Hsinchu, Taiwan.
World J Surg. 2011 Jun;35(6):1321-6. doi: 10.1007/s00268-011-1081-z.
We aimed to study whether positron emission tomography/computed tomography (PET/CT) findings are associated with lymph node staging, as outlined by the 7th edition American Joint Committee on Cancer (AJCC) TNM staging system in patients with esophageal squamous cell carcinoma (ESCC).
A series of 76 ESCC patients undergoing esophagectomy were included in this study. The relation between PET/CT findings [maximum standardized uptake value (SUVmax)] and pathologic lymph node status (N stage) was studied.
The SUVmax of extra-tumor uptake, but not that of the main tumor, was significantly associated with the N classification. N2/N3 disease was observed in 61.1% of patients with an SUVmax for extra-tumor uptake of >4.9, whereas only 17.2% of patients with an SUVmax of extra-tumor uptake of <4.9 were classified as N2/N3 The number of PET abnormalities (NPAs) was also significantly associated with the N classification. Patients with three or more NPAs had a 65% chance of being classified as N2/N3, whereas patients with one or two NPAs had less than a 20% chance of being classified as N2/N3.
The SUVmax of extra-tumor uptake and the NPAs were significantly associated with the N classification outlined by the 7th edition of the AJCC TNM staging system. PET/CT does help identify patients with advanced lymph node metastasis (N2/N3 stage) instead of simply indicating nodal involvement.
本研究旨在探讨食管鳞癌（ESCC）患者正电子发射断层扫描/计算机断层扫描（PET/CT）表现与第 7 版美国癌症联合委员会（AJCC）TNM 分期系统淋巴结分期的关系。
本研究纳入了 76 例行食管切除术的 ESCC 患者。研究了 PET/CT 表现（最大标准化摄取值[SUVmax]）与病理淋巴结状态（N 分期）之间的关系。
肿瘤外摄取 SUVmax 与 N 分类显著相关，而主肿瘤 SUVmax 与 N 分类无显著相关性。肿瘤外摄取 SUVmax>4.9 的患者中，N2/N3 疾病占 61.1%，而肿瘤外摄取 SUVmax<4.9 的患者中，N2/N3 疾病仅占 17.2%。PET 异常数（NPAs）也与 N 分类显著相关。NPAs 为 3 个或更多的患者有 65%的机会被分类为 N2/N3，而 NPAs 为 1 个或 2 个的患者被分类为 N2/N3 的机会小于 20%。
肿瘤外摄取 SUVmax 和 NPAs 与第 7 版 AJCC TNM 分期系统的 N 分期显著相关。PET/CT 有助于确定具有高级淋巴结转移（N2/N3 期）的患者，而不仅仅是指示淋巴结受累。
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