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近年来,随着螺旋CT的推广和低剂量CT肺癌筛查的普及[1],早期肺癌尤其是ⅠA期肺癌的检出率逐年增高。非小细胞肺癌 (non-small cell lung cancer,NSCLC) 是最常见的肺癌类型,不同分期NSCLC的治疗方案和预后差异很大,因此,准确的分期诊断极为重要。根据国际肺癌研究协会第8版TNM分期诊断标准,肺癌原发灶大小≤3 cm且未侵犯相邻脏器、淋巴结无转移(N0)且无远处转移(M0)者为ⅠA期[2]。通常采用根治性手术切除治疗ⅠA期NSCLC,大部分患者可治愈,因此早期诊断、准确识别ⅠA期NSCLC成为有效提高患者生存期和治愈率的重要手段。18F-FDG PET/CT 兼具肿瘤糖代谢分子影像和CT解剖影像的优势,且全身成像的模式特别适合肿瘤分期诊断。众多研究结果[3-5]均证实,18F-FDG PET/CT诊断、分期诊断和再分期诊断NSCLC的准确率较常规影像学方法更高,其对制定NSCLC诊断和治疗策略具有很好的参考价值。
鉴于18F-FDG PET/CT的这些优势,将其应用于ⅠA期NSCLC值得深入研究。目前针对18F-FDG PET/CT在ⅠA期NSCLC临床应用中的研究比较少。我们重点综述了近年来18F-FDG PET/CT在ⅠA期NSCLC患者诊疗中的研究以及这些研究结果对临床决策及预后的价值。
18F-FDG PET/CT在ⅠA期非小细胞肺癌患者诊疗中的研究进展
Research progress of 18F-FDG PET/CT in the diagnosis and treatment of patients with stage ⅠA non-small cell lung cancer
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摘要: 肺癌是目前世界上最常见的癌症之一,随着低剂量CT肺癌筛查的普及,ⅠA期非小细胞肺癌(NSCLC)的检出率逐年增高。18F-氟脱氧葡萄糖(FDG)PET/CT作为一种可从分子水平上反映肿瘤细胞代谢状态的显像方法,已成为NSCLC诊断、分期和预后预测的重要工具。PET/CT在ⅠA期NSCLC中的临床应用逐年增多,笔者就近年来涉及到18F-FDG PET/CT在ⅠA期NSCLC患者中应用的研究以及这些研究结果对临床决策及预后的价值进行综述。
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关键词:
- 癌,非小细胞肺 /
- 氟脱氧葡萄糖F18 /
- 正电子发射断层显像术 /
- 最大标准化摄取值 /
- 亚肺叶切除术
Abstract: Lung cancer is one of the most common cancers in the world. With the popularization of low-dose CT lung cancer screening, the detection rate of stage ⅠA non-small cell lung cancer (NSCLC) is increasing. 18F-fluorodeoxyglucose (FDG) PET/CT as an imaging method to reflect the metabolic state of tumor cells at the molecular level, has become an important tool for the diagnosis, staging and prognosis of NSCLC. The clinical application of PET/CT in stage ⅠA NSCLC is increasing year by year. This paper reviews the research related to the application of 18F-FDG PET/CT in stage ⅠA NSCLC patients in recent years, and the value of these researches in clinical decision-making and prognosis. -
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