18F-FDG PET显像在非小细胞肺癌临床分期中的价值

目的 探讨^18F-脱氧葡萄糖-正电子发射体层显像(^18F-FDG PET)在非小细胞肺癌(NscLC)临床分期中的价值。方法 105例NSCLC患者于放射治疗前行^18F-FDG PET检查,进行PET分期,并将PET分期和CT分期结果进行比较分析。结果 ^18F-FDG PET扫描使38例NSCLC患者分期改变,其中分期升级31例,分期降级7例。21例分期升级者PET检查发现了远处转移灶,其治疗方案由根治性治疗改为姑息性治疗;6例分期降级者进行了根治性手术治疗,其中5例PET分期与病理分期一致。PET发现远处转移灶的几率随PET扫描前分期的升级而上升,其中Ⅰ期10．0％(2／20),Ⅱ期14．3％(3／21),Ⅲ期25．0％(16／64)。结论 ^18F-FDG PET显像改变了36．2％(38／105)NSCLC患者的临床分期,影响了其治疗策略。^18F-FDG PET显像对NSCLC患者的临床分期有重要的参考价值。

Value of 18F-FDG PET in clinical staging of non-small-cell lung cancer

OBJECTIVE: To evaluate the feasibility of 18F-deoxyglucose positron emission tomography (18F-FDG PET) in the staging of non-small-cell lung cancer (NSCLC). METHODS: 105 patients with NSCLC had been examined by 18F-FDG PET and staged by PET before radiotherapy. The results of 18F-FDG PET examination were compared with those of CT. RESULTS: The staging was changed in 38 patients because of 18F-FDG PET findings with PET upstaged in 31 patients and downstaged in 7 patients. Because of distant metastasis detected by PET, 21 patients received palliative treatment. Six of the 7 downstaged patients underwent radical surgery, among which the PET findings were concordant with the operative findings in 5 patients. Distant metastasis detected by PET increased with elevation of pre-PET stage: at stage I 10.0% (2/20), stage II 14.3% (3/21) and stage III 25.0% (16/64), respectively. CONCLUSION: 18F-FDG PET, by changing clinical staging in 36.2% (38/105) NSCLC patients has impact on treatment strategy in NSCLC patients.