^（18）F-FDG符合线路正电子显像评价非小细胞肺癌手术或放化疗疗效价值

目的观察非小细胞肺癌患者手术及放、化疗前、后18F-FDG摄取率变化,探讨18 F-FDG符合线路正电子显像在评价非小细胞肺癌手术及放、化疗疗效中的价值。方法 98例非小细胞肺癌患者,其中单纯行手术治疗46例,单纯放疗16例,单纯化疗11例,放疗＋化疗25例;手术治疗者分别于术前1周及术后3个月,放疗和/或化疗者分别于放、化疗前1周及放、化疗结束后2个月行18F-FDG符合线路正电子显像,勾画原发灶感兴趣区,计算病灶治疗前摄取比值（R1）与治疗后摄取比值（R2）。结果与组织病理结果进行对照,18 F-FDG符合线路正电子显像治疗前诊断非小细胞肺癌的符合率为100%（98/98）;治疗后提示肿瘤残留8例,复发35例,转移27例;不同临床分期、原发灶直径、病理类型患者治疗后R2值均低于治疗前R1值（P〈0.05）;临床分期Ⅰ期患者R1值（2.95±0.36）低于Ⅱ、Ⅲ、Ⅳ期患者（4.24±1.38、5.47±1.69、7.51±1.53）（P〈0.05）,R2值（0.97±0.12）低于Ⅳ期患者（1.42±0.28）（P〈0.05）;原发灶直径≥3cm者R1值（6.13±1.56）高于直径〈3cm者（3.92±1.09）（P〈0.05）;鳞癌、腺癌、大细胞癌患者R1、R2值比较差异无统计学意义（P〉0.05）。结论 18 F-FDG符合线路正电子显像在非小细胞肺癌诊断及评估手术及放、化疗疗效中有重要价值;非小细胞肺癌患者18F-FDG摄取比值可能与术前肿瘤分期和原发灶直径有关。

Value of 18F-FDG coincidence SPECT imaging to evaluating the effect of operation and chemoradiotherapy for non-small cell lung cancer

Objective To explore the value of 18F-FDG coincidence SPECT imaging to evaluating the effect of operation and chemoradiotherapy on non-small cell lung cancer（NSCLC）by observing the changes of 18F-FDG uptake.Methods In98 patients with NSCLC,46 were performed operation,16 received only radiotherapy,11 received only chemotherapy,and 25 received radiotherapy plus chemotherapy.18F-FDG coincidence SPECT imaging was performed one week before and three months after operation,and one week before and two months after chemotherapy and/or radiotherapy.The uptake ratio（R）before and after treatment was calculated by outlining the region of interest of lesions.Results The diagnostic coincidence rate of 18F-FDG before operation to histopathological results was 100%（98/98）.18F-FDG showed residual tumor in 8,recurrence in 35,and cancer metastasis in 27 after treatment.R2 after treatment was lower than R1 before treatment in patients with different stages and different diameters of primary focus（P〈0.05）.R1 was lower in stageⅠ patients（2.95±0.36）than that in clinical stageⅡ,Ⅲ and Ⅳ patients（4.24±1.38,5.47±1.69,7.51±1.53）（P〈0.05）,and R2 was lower（0.97±0.12）than that in stageⅣ patients（1.42±0.28）（P〈0.05）.R1 was higher in patients with diameter of primary focus≥3cm（6.13±1.56）than that in patients with diameter of primary focus3cm（3.92±1.09）（P〈0.05）.There were no significant differences in R1 and R2in patients with squamous cell carcinoma,adenocarcinoma and large cell carcinoma（P〈0.05）.Conclusion 18F-FDG coincidence SPECT plays an important role in the diagnosis of NSCLC and the evaluation of the effect of operation and chemoradiotherapy,and18F-FDG uptake ratio may be correlated with the preoperative tumor staging and the diameter of primary locus.