FDG-PET in staging lung cancer - How does it change the algorithm?
FDG-PET in staging lung cancer - How does it change the algorithm?
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DOI：
10.1016/j.lungcan.2003.11.007
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发表时间：
2004-05-01
期刊：
影响因子：
5.3
通讯作者：
Oyen, WJG
中科院分区：
文献类型：
--
作者：
Verhagen, AFT;Bootsma, GP;Oyen, WJG
背景资料：在肺癌患者中，使用氟-18-氟脱氧葡萄糖（FDG）的正电子发射断层扫描（PET）可用于检测胸外转移（ETM）和纵隔淋巴结分期（MLS），可能减少纵隔镜检查的需要。我们评估了FDG-PET检测ETM的附加值，并专注于FDG-PET和纵隔镜检查MLS.Patients和方法的可靠性：在72例连续非小细胞肺癌患者中，FDG-PET的影响，增加到完整的常规临床分期进行了前瞻性分析。FDG-PET的结果和肿瘤的病理纵隔淋巴结状态的预测价值进行了评估在logistic回归analysis.Results：意外的胸外转移检测FDG-PET在15%的患者。在MLS中，FDG-PET的阴性和阳性预测值分别为71%和83%，纵隔镜检查的阴性和阳性预测值分别为92%和100%。然而，FDG-PET的阴性预测值只有17%的情况下，FDG-PET阳性N1节点和/或位于中心的原发性肿瘤，而它是96%的情况下，FDG-PET阴性N1节点和非位于中心的原发性tumor.Conclusion：通过将FDG-PET在临床分期，15%的肺癌患者是upstaged由于意想不到的胸外转移。在纵隔FDG-PET阴性的情况下，只有在存在非中心定位的原发性肿瘤并且没有FDG-PET阳性N1淋巴结时才可以省略纵隔镜检查。(C)2003爱思唯尔爱尔兰有限公司保留所有权利。
Background: In patients with lung cancer, positron emission tomography (PET) using fluor-18-fluorodesoxyglucose (FDG) may be used both to detect extrathoracic metastases (ETM) and for mediastinal lymph node staging (MLS), potentially reducing the need for mediastinoscopy. We assessed the added value of FDG-PET in detecting ETM and focused on the reliability of FDG-PET and mediastinoscopy for MLS.Patients and methods: In 72 consecutive patients with non-small cell Lung cancer, the impact of adding FDG-PET to full conventional clinical staging was prospectively analyzed. The predictive value of FDG-PET findings and tumor Location for pathologic mediastinal lymph node status were assessed in a logistic regression analysis.Results: Unexpected extrathoracic metastases were detected by FDG-PET in 15% of patients. In MLS overall negative and positive predictive values were 71 and 83% for FDG-PET, and 92 and 100% for mediastinoscopy. However, the negative predictive value of FDG-PET was only 17% in case of FDG-PET positive N1 nodes and/or a centrally located primary tumor, whereas it was 96% in case of FDG-PET negative N1 nodes and a non-centrally located primary tumor.Conclusion: By incorporating FDG-PET in clinical staging, 15% of patients with Lung cancer are upstaged due to unexpected extrathoracic metastases. In case of a negative mediastinal FDG-PET, mediastinoscopy can only be omitted in the presence of a non-centrally located primary tumor and without FDG-PET positive N1 nodes. (C) 2003 Elsevier Ireland Ltd. All rights reserved.