ANALYSIS OF FACTORS THAT AFFECT THE NEGATIVE PREDICTIVE VALUE OF 18F-FDG PET/CT IN THE DIAGNOSIS OF MEDIASTINAL LYMPH NODE METASTASIS IN PATIENTS WITH NON-SMALL CELL LUNG CANCER
Objective To identify factors that affect the negative predictive value of 18F-FDG PET/CT in the diagnosis of mediastinal lymph node metastasis in non-small cell lung cancer (NSCLC) and to improve its diagnostic accuracy.Methods A total of 171 NSCLC patients with preoperative stage Ⅰ NSCLC who underwent pulmonary lobectomy and systemic lymphadenectomy from January 2013 to December 2016 in our hospital were included in this study.All patients were examined by 18F-FDG PET/CT,and imaging showed no abnormal radioactive uptake in the mediastinal lymph node.According to the postoperative pathological results,31 patients with lymph node metastasis were classified as group A,and 140 patients without lymph node metastasis were classified as group B.The clinicopathological features were compared between the two groups.Results Group A had a significantly higher percentage of female patients (x2 =-4.401,P＜0.05) and a significantly shorter smoking history (t =15.924,P＜0.05) compared with group B.The maximum standard absorption value and metabolic tumor volume (MTV) of primary lesions measured by 18F-FDG PET/CT were significantly greater in group A than in group B (t =3.616 and 3.630,both P＜0.05).As for postoperative pathologic features,the proliferation marker Ki67,diameter of primary lesion,and percentage of patients with high epidermal growth factor receptor expression were significantly higher in group A than in group B (t =2.465 and 3.112,x2 =30.118,all P＜0.05).Multivariate logistic analysis showed that MTV of the primary lesion was a risk factor for postoperative lymph node metastasis.Conclusion For NSCLC patients with no indication of mediastinal lymph node metastasis by 18F-FDG PET/CT,clinical and pathological factors should also be examined to determine the presence or absence of metastasis.Mediastinal lymph node biopsy is recommended for patients who are highly suspected of mediastinal lymph node metastasis.
positron-emission tomography and computed tomographycarcinoma, non-small-cell lungmediastinumlymphatic metastasisdiagnosisroot cause analysis
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