PET-CT 显像在卵巢恶性肿瘤淋巴结转移诊断中的临床价值

目的：探讨PET-CT显像对卵巢恶性肿瘤淋巴结转移的诊断价值。方法对52例卵巢恶性肿瘤患者（初治39例、复发13例）于手术前采用PET-CT检测预测腹膜后淋巴结转移状况及位置。初治患者行卵巢癌肿瘤细胞减灭术同时行腹膜后淋巴结清扫术，复发患者行病灶及区域淋巴结清扫术。将术前PET-CT检测结果与术后淋巴结病理检查结果进行对照，计算PET-CT检测诊断卵巢恶性肿瘤淋巴结转移的敏感性、特异性、准确性、阳性预测值和阴性预测值。结果 PET-CT显像诊断腹膜后淋巴结转移的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为96．30％（26/27）、92．00％（23/25）、94．23％（49/52）、92．86％（26/28）和95．83％（23/24）；诊断腹主动脉旁淋巴结转移的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为96．30％（26/27）、100．％（25/25）、98．08％（51/52）、100％（26/26）和96．15％（25/26）；诊断盆腔淋巴结转移的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为90．91％（10/11）、95．12％（39/41）、94．23％（49/52）、83．33％（10/12）和97．50％（39/40）。结论 PET-CT在卵巢恶性肿瘤淋巴结转移诊断方面有较高的临床价值。

Diagnostic value of PET-CT in detection of lymph node metastasis in malignant ovarian tumor

Objective To investigate the diagnostic value of positron emission tomography and computed tomography （ PET-CT） in lymph node metastasis of malignant ovarian tumor .Methods Totally fifty-two patients with malignant ovari-an cancer were collected , including 39 primary and 13 reoccurred patients .PET-CT was performed to forecast the status and position of retroperitoneal lymph node before surgery .Cytoreductive surgery combined with retroperitoneal lymph node dissection was done on the primary patients , lesions and regional lymph node dissection was done on the reoccurred pa-tients.The results of PET-CT detection and pathological examination of lymph node before and after surgery were com -pared, and then the sensitivity, specificity, accuracy, positive predictive value （PPV）, and negative predictive value （ NPV） of PET-CT detection in lymph node metastasis of malignant ovarian tumor were calculated .Results The sensitivi-ty, specificity, accuracy, PPV, and NPV of PET-CT in diagnosing retroperitoneal lymph node metastasis were 96.30%（26/27）, 92.00%（23/25）, 94.23%（49/52）, 92.86%（26/28） and 95.83%（23/24）, respectively.The sensitivi-ty, specificity, accuracy, PPV, and NPV of PET-CT in diagnosing para-aortic lymph node metastasis were 96.30%（26/27）, 100.00%（25/25）, 98.08%（51/52）, 100.00%（26/26） and 96.15%（25/26）, respectively.The sensitivity, specificity, accuracy, PPV, and NPV of PET-CT in diagnosing pelvic lymph node metastasis were 90.91% （10/11）, 95.12%（39/41）, 94.23%（49/52）, 83.33%（10/12） and 97.50%（39/40）, respectively.Conclusions PET-CT detection of lymph node metastasis in malignant ovarian tumor shows an accurate diagnostic value .