目的:比较PET/CT与常规检查(CWU)评估鼻咽癌远处转移的诊断效能。方法:将514例鼻咽癌患者分为PET/CT及CWU两组,CWU组采用胸片、B超及全身骨扫描评估远处转移病灶,分析对比两组检查结果。结果:PET/CT组216例中报告远处转移32例,均证实报告准确;CWU组298例中报告可疑转移患者42例,其中28例证实为远处转移,另有3例远处转移未检出。两组检查敏感性分别为100.0%(32/32)和90.3%(28/31),特异性分别为100.0%(184/184)和94.8%(253/267),差异均无统计学意义。PET/CT组N2-3分期远处转移率、多发转移及多器官转移患者比例均高于CWU组(P〈0.01或0.05)。结论:PET/CT检查稍优于CWU,但临床实践中CWU仍是价廉、实用的方法。
Objective: The large sample retrospective cohort study were used to compare the diagnostic efficiency of PET/CT with conventional work-up(CWU) for evaluating nasopharyngeal carcinoma(NPC) distant metastasis. Method:Five hundred and fourteen patients with NPC were divided into PET/CT group and CWU group according the method of detecting distant metastasis. Chest film, abdominal ultrasonography, and bone scan were used in CWU group . Then the diagnostic efficiency of the two groups was compared. Result: Two hundred and sixteen patints were enrolled in PET/CT group and two hundred and nineteen-eight ones in CWU group. There were 28 out of 3.2 suspicious patients in CWU group were confirmed, another 3 patients confirmed without positive findings, compared with PET/CT group that all 32 suspicious patients were confirmed. The sensitivity and speci- ficity of PET/CT were 100.0%(32/32) and 100.0%(184/184), as compared to 90.3%(28/31) and 94.8%(253/ 267) with CWU respectively, while there was no statistical significance. Further research found out that the percentage of patients with multiple distant metastatic sites and multiple organ metastases was higher in PET/CT group(P〈0.05), and similarly of patients with distant metastasis in N23 stages(P〈0.01). Conclusion: Our results suggest that PET/CT appears to be slightly superior to conventional work-up in assessment of distant metastasis in NPC patients, hut CWU is still a cheap and practical method.