Department of Radiation Oncology, Key Laboratory of Radiation Oncology of Shandong Province, Jinan, China.
Radiother Oncol. 2012 Feb;102(2):246-50. doi: 10.1016/j.radonc.2011.10.016. Epub 2011 Nov 17.
Accurate staging of mediastinal lymph nodes metastases is critical for determining the application of stereotactic body radiation therapy (SBRT) for patients with early stage non-small cell lung cancer (NSCLC). In this multicenter study the accuracy of (18)F-FDG PET/CT to detect lymph node metastases was evaluated for early stage NSCLC.
The data from the patients with stage1 NSCLC who received preoperative (18)F-FDG PET/CT staging and radical surgery was retrospectively reviewed of five centers from February 2004 to August 2010. The lymph node metastases were confirmed histopathologically after radical surgery. And the sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were calculated for PET/CT staging.
Two hundred patients were enrolled. The sensitivity, specificity, accuracy, PPV and NPV for lymph node metastases on PET/CT were 44%, 83%, 78%, 29% and 91%, respectively. There were eight and 19 cases positive for lymph node metastases with central (n=62) and peripheral (n=138) NSCLC (P>0.05), respectively.
(18)F-FDG PET/CT was specific in N(0) staging for T(1-2) NSCLC. The NPV was about 91% in clinical N(0) patients, suggested that (18)F-FDG PET/CT may help to accurately stage N(0) patients and thus identify patients for SBRT.
准确分期纵隔淋巴结转移对确定早期非小细胞肺癌（NSCLC）患者立体定向体部放疗（SBRT）的应用至关重要。在这项多中心研究中，评估了（18）F-FDG PET/CT 检测早期 NSCLC 淋巴结转移的准确性。
回顾性分析了 2004 年 2 月至 2010 年 8 月 5 个中心接受术前（18）F-FDG PET/CT 分期和根治性手术的 I 期 NSCLC 患者的数据。根治性手术后通过组织病理学证实了淋巴结转移。并计算了 PET/CT 分期的敏感性、特异性、准确性、阳性预测值（PPV）和阴性预测值（NPV）。
共纳入 200 例患者。PET/CT 对淋巴结转移的敏感性、特异性、准确性、PPV 和 NPV 分别为 44%、83%、78%、29%和 91%。中央型（n=62）和周围型（n=138）NSCLC 患者的淋巴结转移阳性分别为 8 例和 19 例（P>0.05）。
（18）F-FDG PET/CT 对 T（1-2）NSCLC 的 N（0）分期具有特异性。临床 N（0）患者的 NPV 约为 91%，表明（18）F-FDG PET/CT 可能有助于准确分期 N（0）患者，从而识别适合 SBRT 的患者。
