Abstract:Objective: To explore the clinical value of spiral CT and PET-CT scan in the diagnosis of lung cancer and lymph node metastasis. Methods: 96 patients with lung cancer and suspected lymph node metastasis admitted to our hospital from January 2018 to August 2019 were selected. Within 2 weeks, spiral CT and PET-CT were performed. Based on the final surgical and pathological results, the efficacy of the two diagnostic methods in the diagnosis of lung cancer and lymph node metastasis was compared. Results: The results of surgical pathology showed that among 96 patients with suspected lung cancer lymph node metastasis, 22 had no lymph node metastasis and 74 had lymph node metastasis. Among them, 32 had local recurrence lesions; a total of 102 metastatic lymph nodes were detected, of which diameter There are 6 metastatic lymph nodes of ≤0.5cm, 75 metastatic lymph nodes of 0.5 ~ 1.0cm, and 21 metastatic lymph nodes of diameter ≥1.0cm. The accuracy, sensitivity, specificity, positive prediction rate, and negative prediction rate of spiral CT and PET-CT in the diagnosis of lung cancer lymph nodes were 75.0%, 74.3%, 77.3%, 91.7%, 47.2%; 94.8%, 97.4%, 86.4% , 96.0%, 90.5%. In the detection of metastatic lymph nodes, the total detection rate of PET-CT was significantly higher than that of spiral CT (P<0.05). In the detection of metastatic lymph nodes, the total detection rate of PET-CT was significantly higher than that of spiral CT (P<0.05). Among them, the detection rate of PET-CT was significantly higher than that of spiral CT on ≤0.5cm and 0.5-1.0cm metastatic lymph node metastasis, and the difference was statistically significant (P<0.05); on ≥1.0cm metastatic lymph node, neither Significant difference, not statistically significant (P>0.05). Conclusion: Compared with spiral CT diagnosis, PET-CT diagnosis of lung cancer and lymph node metastasis diagnostic efficiency is more significant, with clinical application value, but the cost is higher, broad-spectrum is weak, so it can be used as a further diagnostic means to improve the diagnostic accuracy when spiral CT is difficult to determine.
王家富, 林琳, 林耀云, 王杨, 王洋洋, 李勇. 螺旋CT和PET-CT扫描诊断肺癌及淋巴结转移的临床价值[J]. 河北医学, 2021, 27(2): 283-287.
WANG Jiafu, LIN Lin, LIN Yaoyun, et al. Clinical Value of Spiral CT and PET-CT in the Diagnosis of Lung Cancer and Lymph Node Metastasis. HeBei Med, 2021, 27(2): 283-287.
[1] Liyu,Su,Mingqiu,Chen,Huiyan,Su,et al. Postoperative chemoradiotherapy is superior to postoperative chemotherapy alone in squamous cell lung cancer patients with limited N2 lymph node metastasis. [J]. BMC cancer,2019,19(1):1023. [2] Jae Kwang,Yun,Geun Dong,Lee,Sehoon,Choi,et al. Comparison between lymph node station- and zone-based classification for the future revision of node descriptors proposed by the International Association for the Study of Lung Cancer in surgically resected patients with non-small-cell lung cancer. [J]. European journal of cardio-thoracic surgery :official journal of the European Association for Cardio-thoracic Surgery,2019,56(5):849~857. [3] 周礼平,陈馨,蒋晓兰.64排螺旋CT灌注成像参数对肺癌患者肺门及纵隔淋巴结转移的预测价值[J].广西医科大学学报,2017,34(10):1500~1501. [4] 王铮,胡述提,张洁,等.PET-CT在肺癌术前诊治中的应用[J].中国CT和MRI杂志,2019,17(3):11~14. [5] Jie,Yang,Aimei,Peng,Bo,Wang,et al. The prognostic impact of lymph node metastasis in patients with non-small cell lung cancer and distant organ metastasis. [J]. Clinical & experimental metastasis,2019,36(5):457~466. [6] 王小刚,杨茂生,彭君,等.64排螺旋CT术前增强扫描在辅助诊断非小细胞肺癌淋巴结转移的应用价值分析[J].中国实验诊断学,2018,22(5):777~780. [7] 曹晓琴,殷捷.多层螺旋CT三维重建对肺癌诊断及淋巴转移的预测价值[J].中国临床研究,2017,30(6):835~837. [8] 朱思光,孙倩.18氟-氟代脱氧葡萄糖-正电子发射体层显像/计算机体层成像测定密度比在诊断非小细胞肺癌纵隔淋巴结转移中的应用价值[J].实用临床医药杂志,2019,23(1):18~21. [9] 殷志敏,刘庆文,游杰,等.术前PET/CT检查在指导非小细胞肺癌淋巴结清扫中的临床意义[J].江苏医药,2019,45(8):800~802. [10] 曾奕菲,柯元,李永红,等.应用PET/CT分析非小细胞肺癌锁骨上淋巴结转移规律及其对放疗靶区设计的意义[J].武汉大学学报(医学版),2019,40(4):569~572. [11] 丁重阳,郭喆,孙晋,等.18F-FDGPET/CT预测周围型非小细胞肺癌小病灶隐匿性淋巴结转移的价值[J].中华核医学与分子影像杂志,2018,38(7):493~494. [12] 张毓艺,姚稚明,陈聪霞,等.FDGPET/CT原发性代谢对非小细胞肺癌区域淋巴结转移预测价值[J].中华肿瘤防治杂志,2018,25(11):816~820.