Nam Kyung Bum, Kim Tae Jung, Park Jeong-Soo, Chung Myung Jin, Lee Kyung Won
From the Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si (KBN, TJK, KWL); and Department of Biochemistry, College of Medicine, Dankook University, Cheonan, Korea (J-SP).
Medicine (Baltimore). 2016 Jan;95(4):e2634. doi: 10.1097/MD.0000000000002634.
The purpose of our study was to retrospectively evaluate the value of F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for postoperative surveillance of lung adenocarcinoma manifesting as ground-glass opacity (GGO).From May 2003 to December 2007, 111 patients with surgically resected lung adenocarcinoma manifesting as GGO were included. Clinical findings of recurrence and survival, CT features, and maximum standardized uptake value (SUVmax) were reviewed and compared among 3 groups according to GGO proportion: Group I, GGO 100%; Group II, GGO ≥50%; Group III, GGO < 50%. Disease-free survival (DFS) was estimated using the Kaplan-Meier method. Diagnostic performances of CT and PET/CT for recurrence were compared during a long-term follow-up period of >5 years.Recurrence was identified in Group III (18 of 53, 34%) but not in Groups I (n = 25) or II (n = 33) over a mean follow-up period of 74 months. Group showed significant differences in GGO proportion, SUVmax, and DFS duration (P < 0.001). PET/CT led to 6 false-positive and 5 false-negative interpretations of recurrence. For surveillance CT, sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 94.4%, 98.6%, 98.2%, 94.4%, and 98.9%, respectively; for PET/CT, sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 72.2%, 92.3%, 88.5%, 68.4%, and 93.5%, respectively. CT showed significantly higher accuracy than PET/CT (P = 0.0188).FDG-PET/CT showed no clear advantage for postoperative surveillance of lung cancer with predominant GGO because of low incidence of recurrence and frequent false-positive and false-negative results.
我们研究的目的是回顾性评估F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）对表现为磨玻璃影（GGO）的肺腺癌术后监测的价值。2003年5月至2007年12月，纳入111例手术切除的表现为GGO的肺腺癌患者。根据GGO比例将患者分为3组：I组，GGO 100%；II组，GGO≥50%；III组，GGO＜50%，对3组患者的复发和生存临床结果、CT特征及最大标准化摄取值（SUVmax）进行回顾和比较。采用Kaplan-Meier法估计无病生存期（DFS）。在超过5年的长期随访期内比较CT和PET/CT对复发的诊断性能。在平均74个月的随访期内，III组（53例中的18例，34%）出现复发，而I组（n = 25）和II组（n = 33）未出现复发。3组在GGO比例、SUVmax和DFS持续时间方面存在显著差异（P＜0.001）。PET/CT对复发的判断有6例假阳性和5例假阴性。对于监测CT，其敏感性、特异性、准确性、阳性预测值和阴性预测值分别为94.4%、98.6%、98.2%、94.4%和98.9%；对于PET/CT，其敏感性特异性、准确性、阳性预测值和阴性预测值分别为72.2%、92.3%、88.5%、68.4%和93.5%。CT的准确性显著高于PET/CT（P = 0.0188）。由于复发率低且假阳性和假阴性结果频繁，FDG-PET/CT对以GGO为主的肺癌术后监测没有明显优势。
