Damirov Fuad, Stoleriu Mircea Gabriel, Manapov Farkhad, Büsing Karen, Michels Julia Dorothea, Preissler Gerhard, Hatz Rudolf A, Hohenberger Peter, Roessner Eric D
Department of Thoracic Surgery, Ludwig Maximilian University of Munich, 81377 Munich, Germany.
Department of Surgery, Division of Surgical Oncology and Thoracic Surgery, University Hospital Mannheim, University of Heidelberg, 68167 Mannheim, Germany.
Diagnostics (Basel). 2023 May 29;13(11):1893. doi: 10.3390/diagnostics13111893.
This study aimed to evaluate the diagnostic accuracy and false positivity rate of lymph node (LN) staging assessed by integrated 18F-fluorodeoxyglucose positron emission computed tomography (18F-FDG-PET/CT) in patients with operable lung cancer to the tumor histology. In total, 129 consecutive patients with non-small-cell lung cancer (NSCLC) undergoing anatomical lung resections were included. Preoperative LN staging was evaluated in the relationship to the histology of the resected specimens (group 1: lung adenocarcinoma/LUAD; group 2: squamous cell carcinoma/SQCA). Statistical analysis was performed by the Mann-Whitney U-test, the chi test, and binary logistic regression analysis. To establish an easy-to-use algorithm for the identification of LN false positivity, a decision tree including clinically meaningful parameters was generated. In total, 77 (59.7%) and 52 (40.3%) patients were included in the LUAD and SQCA groups, respectively. SQCA histology, non-G1 tumors, and tumor SUVmax > 12.65 were identified as independent predictors of LN false positivity in the preoperative staging. The corresponding ORs and their 95% CIs were 3.35 [1.10-10.22], = 0.0339; 4.60 [1.06-19.94], = 0.0412; and 2.76 [1.01-7.55], and = 0.0483. The preoperative identification of false-positive LNs is an important aspect of the treatment regimen for patients with operable lung cancer; thus, these preliminary findings should be further evaluated in larger patient cohorts.
本研究旨在评估采用18F-氟脱氧葡萄糖正电子发射计算机断层扫描（18F-FDG-PET/CT）对可手术肺癌患者进行淋巴结（LN）分期的诊断准确性及假阳性率与肿瘤组织学的关系。总共纳入了129例连续接受解剖性肺切除术的非小细胞肺癌（NSCLC）患者。术前对LN分期与切除标本的组织学进行相关性评估（第1组：肺腺癌/LUAD；第2组：鳞状细胞癌/SQCA）。采用曼-惠特尼U检验、卡方检验和二元逻辑回归分析进行统计分析。为建立一种易于使用的识别LN假阳性的算法，生成了一个包含具有临床意义参数的决策树。LUAD组和SQCA组分别纳入了77例（59.7%）和52例（40.3%）患者。SQCA组织学、非G1肿瘤以及肿瘤SUVmax>12.65被确定为术前分期中LN假阳性的独立预测因素。相应的比值比（OR）及其95%置信区间（CI）分别为3.35 [1.10 - 10.22]，P = 0.0339；4.60 [1.06 - 19.94]，P = 0.0412；以及2.76 [1.01 - 7.55]，P = 0.0483。术前识别假阳性LN是可手术肺癌患者治疗方案的一个重要方面；因此，这些初步发现应在更大的患者队列中进一步评估。
