Zhang Weishan, Liu Zhe, Duan Xiaoyi, Li Yan, Shen Cong, Guo Youmin, Yang Jian
PET/CT Department of the First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Radiology Department of the First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Front Oncol. 2023 Jun 30;13:1192870. doi: 10.3389/fonc.2023.1192870. eCollection 2023.
To explore the clinical role of F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) in differentiating malignant pleural effusion (MPE) from benign pleural effusion (BPE) in patients with lung cancer.
Over a 8-year period, we retrospectively reviewed PET/CT data of lung cancer patients with pleural effusion, with 237 participants enrolled for analysis. The nature of pleural effusion was confirmed using pleural cytology or biopsy. MPE versus BPE comparison and multiple regression analysis were performed. Receiver operating characteristic (ROC) curve analysis was used for evaluating the diagnostic performance.
Of the 237 participants, 170 had MPEs and 67 had BPEs. Compared with BPEs, MPEs had higher pleural SUVmax and thicker pleura and were more common among non-small cell lung cancers, peripheral tumors, and women (p < 0.05). BPEs had larger and higher F-FDG uptake thoracic lymph nodes and more complications of pneumonia (p < 0.05) than MPEs. Multiple regression analysis was used to identify the pleural SUVmax (odds ratio, OR = 38.8), sex (OR = 0.033), and mediastinal lymphoid node size (OR = 0.86) as independent risk factors for MPEs. The sensitivity, specificity, and area under the ROC curve (AUC) in the combined ROC curve analysis by using the three factors were 95.3%, 95.5%, and 0.989, respectively.
F-FDG PET/CT integrated imaging is an effective non-invasive method for differential diagnosis of MPE in patients with lung cancer. Pleural SUVmax combined with thoracic lymph nodes and sex has high diagnostic value.
探讨¹⁸F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（¹⁸F-FDG PET/CT）在肺癌患者中鉴别恶性胸腔积液（MPE）与良性胸腔积液（BPE）的临床作用。
在8年期间，我们回顾性分析了肺癌伴胸腔积液患者的PET/CT数据，纳入237例参与者进行分析。通过胸腔细胞学检查或活检确定胸腔积液的性质。进行MPE与BPE的比较及多元回归分析。采用受试者操作特征（ROC）曲线分析评估诊断性能。
237例参与者中，170例为MPE，67例为BPE。与BPE相比，MPE的胸腔SUVmax更高、胸膜更厚，在非小细胞肺癌、周围型肿瘤和女性中更常见（p<0.05）。BPE的¹⁸F-FDG摄取的胸部淋巴结更大、更多，且肺炎并发症比MPE更多（p<0.05）。多元回归分析确定胸腔SUVmax（比值比，OR = 38.8）、性别（OR = 0.033）和纵隔淋巴结大小（OR = 0.86）为MPE的独立危险因素。使用这三个因素进行联合ROC曲线分析时，敏感性、特异性和ROC曲线下面积（AUC）分别为95.3%、95.5%和0.989。
¹⁸F-FDG PET/CT融合成像对于肺癌患者MPE的鉴别诊断是一种有效的非侵入性方法。胸腔SUVmax联合胸部淋巴结及性别具有较高的诊断价值。
