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目的探讨18-FDG-PET检查对肺癌定性的诊断和淋巴结转移情况诊断的价值,评估其对手术选择的参考意义。方法我院呼吸内科和胸外科96例疑似肺癌患者,在PET检查医师和患者双盲的情况下行18-FDG-PET,以病理检查结果作为金标准,对PET检查结果的漏诊率、误诊率、灵敏度、特异度等指标进行分析。结果对肺癌原发病灶的定性诊断误诊率为0,漏诊率为20.7%,灵敏度为79.3%,特异度为100%。对于肿瘤≤2cm的肿瘤漏诊率为20%。42例恶性疾病患者淋巴结转移误诊率为23.5%,漏诊率为40%,灵敏度为60%,特异度为76.5%。结论 PET对肺原发肿物定性诊断的误诊率低,特异性较好,但漏诊率较高,灵敏度尚待提高;对引流淋巴结定性诊断可为医生及患者决定是否手术治疗和手术方式提供有益的参考。对于不愿意接受针吸活检等有创性诊断的患者,先行PET检查是比较理想的选择。
Objective To investigate the diagnostic value of 18-FDG-PET for the diagnosis of lung cancer and lymph node metastasis, and to evaluate the significance of 18-FDG-PET in the diagnosis of lung cancer. Methods Ninety-six patients with suspected lung cancer in our Department of Respiratory Medicine and Thoracic Surgery underwent 18-FDG-PET under the double blindness of physicians and patients undergoing PET examinations. The pathological examination results were taken as the gold standard to evaluate the rate of misdiagnosis, misdiagnosis, Sensitivity, specificity and other indicators for analysis. Results The diagnostic accuracy of primary lung cancer was 0, the rate of misdiagnosis was 20.7%, the sensitivity was 79.3% and the specificity was 100%. The rate of misdiagnosis for tumors ≤ 2 cm is 20%. The misdiagnosis rate of lymph node metastasis in 42 cases of malignant disease was 23.5%, the rate of misdiagnosis was 40%, the sensitivity was 60% and the specificity was 76.5%. Conclusions PET has a low misdiagnosis rate and good specificity for the qualitative diagnosis of primary pulmonary tumor, but its misdiagnosis rate is high and its sensitivity needs to be improved. The qualitative diagnosis of draining lymph nodes can be helpful to doctors and patients in determining whether surgical treatment and operation are beneficial The reference. For those who do not want to accept needle aspiration biopsy and other invasive diagnosis of patients, the first PET examination is the ideal choice.