Analysis The Value Of ¹⁸F-FDG PET/CT Imaging And CT Plain Scan And Enhancement In Preoperative Diagnosis,Staging And Analysis Of Factors Affecting Regional Lymph Node Metastasis Of Laryngeal Carcinoma

Objective:To investigate the value of ¹⁸F-FDG PET/CT whole body imaging and CT plain scan and enhancement in the preoperative diagnosis,staging and analysis of the factors affecting regional lymph node metastasis.Methods:Retrospective analysis of 48 patients with suspected or diagnosed as laryngeal carcinoma with ¹⁸F-FDG PET/CT imaging and CT plain scan and enhancement data,compared the results with pathology and clinical follow-up results.Paired x2 test?or Fisher exact test?between PET/CT imaging and CT plain scan and enhancement in laryngeal carcinoma before treatment of laryngeal carcinoma,laryngeal surrounding tissue invasion and regional lymphnode metastasis diagnostic sensitivity,specificity,consistency,positive predictive value?PPV?,negative predictive value?NPV?and clinical stage of the difference.Region of interest?ROI?method and measure the delineation of laryngeal carcinoma,cervical lymph node metastasis maximum standard uptake value?SUVmax?,calculated the best diagnosis SUVmax of ¹⁸F-FDG PET/CT on laryngeal cancer primary tumor and regional lymph node metastases using the receiver operating characteristic curve?ROC?.Using Logistic regression univariate and multivariate analysis of age,disease duration,primary tumor size,SUVmax,degree of differentiation,T stage,Ki-67,a total of 8 factors of laryngeal tissue around invasion node c in laryngeal carcinoma lymph.Results:1.¹⁸F-FDG PET/CT in the diagnosis of laryngeal cancer primary tumors2.43 cases of laryngeal cancer were confirmed by pathology among 48 people.¹⁸F-FDG PET/CT imaging and CT plain scan and enhancement in diagnosis of laryngeal lesions of the sensitivity,specificity,consistency,positive and negative predictive values were 97.7%?42/43?,60%?3/5?,89.6%?43/48?,95.5%?42/44?,75%?3/4?and 74.4%?32/43?,60%?3/5?,72.9%,?35/48?,94.1%?32/34?,21.4%?3/14?.There was no significant statistical difference?P=0.256?between ¹⁸F-FDG PET/CT and CT plain scan and enhancement in diagnosis of laryngeal cancer primary tumors by Fisher's exact probability analysis method.By the ROC curve calculation,¹⁸F-FDG PET/CT has the highest efficiency respectively in the diagnosis of laryngeal cancer primary when SUVmax is 3.5.A total of 65 suspected lymph nodes of 43 patients with laryngeal cancer were included in the study.Among them,a total of 39 suspected lymph nodes of23 patients with laryngeal cancer were confirmed as metastatic foci,and theother 26 lymph nodes were confirmed to be none metastatic tumors.2.1 Calculate the diagnostic efficacy On the patient-based¹⁸F-FDG PET/CT imaging and CT plain scan and enhancement in diagnosis of laryngeal cancer cervical lymph node metastasis in sensitivity,specificity,consistency,positive predictive value and negative predictive value were 91.3%,75%,83.7%,80.8%,88.2% and 65.2%,75%,69.8%,75%,65.2%.Fisher exact probability analysis,On the patient-based,¹⁸F-FDG PET/CT and CT plain scan and enhancement of cervical lymph node metastasis of the diagnostic sensitivity was no significant difference?P=0.111?.2.2 Calculate the diagnostic effectiveness by the number of lymph nodes¹⁸F-FDG PET/CT and CT plain scan and enhancement the diagnosis of laryngeal cancer with regional lymph node metastasis sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 89.7%,80.8%,86.2%,87.7%,84% and 59%,80.8%,67.7%,82.1%,56.8%.By the Fisher exact probability analysis,the sensitivity of ¹⁸F-FDG PET/CT and CT plain scan and enhancement in the diagnosis of lymph node metastasis of laryngeal cancer was significantly different?P < 0.01?.Calculated by the ROC curve,the diagnostic efficiency was the highest respectively when SUVmax was3.5.3.Diagnosis of peripheral tissue involvementOf the 43 patients with laryngeal carcinoma diagnosed by pathology,there were 14 cases of laryngeal cancer patients with laryngeal tissue involvement.The sensitivity and specificity of ¹⁸F-FDG PET/CT and CT plain scan and enhancement in the diagnosis of cervical lymph node metastasis of laryngeal carcinoma were 100%,93.1% and 57.1%,44.8%,respectively.Paired data chi square test showed that the diagnostic sensitivity of ¹⁸F-FDG PET/CT inlaryngeal carcinoma tissues was significantly higher than that of CT plain scan and enhancement?P < 0.01?.4.¹⁸F-FDG PET/CT in the diagnosis of distant metastases and double carcinomaAmong the 43 cases of laryngeal carcinoma,there were 3 cases of lung metastasis,2 cases of liver metastasis,1 cases of esophageal metastasis,1 cases of gastric metastasis,the other 1 patients with primary gastric diffuse large B cell lymphoma,¹⁸F-FDG PET/CT can accurately display the number of distant metastasis and with double carcinoma lesion site,CT plain scan and enhancement only showed 1 cases of patients with multiple lung metastases.5.The value of ¹⁸F-FDG PET/CT in staging and clinical decision making before trentmentCompared with CT plain scan and contrast enhancement,a total of 37 cases changed the clinical T stage?8 cases were improved and 29 cases were reducd?.The N staging was improved in 6 cases,and the M staging was improved in 7cases.In addition,¹⁸F-FDG PET/CT detected 1 patients with double cancer?laryngeal carcinoma with diffuse large B cell lymphoma?.6.The value of ¹⁸F-FDG PET/CT in the analysis of factors affecting regional lymph node metastasis before treatment of laryngeal carcinomaAnalysis of the duration of single factor Logistic regression model,duration of disease,primary tumor size primary SUVmax,T stage,differentiation,Ki-67 were related to cervical lymph node metastasis of laryngeal cancer,age,tissue around the throat?soft tissue,cartilage?involvement has nothing to do with cervical lymph node metastasis;Multivariate analysis confirmed that primary tumor differentiation and Ki-67 is an independent factor for laryngeal cancer patients with regional lymph node metastasis.Conclusion:1.¹⁸F-FDG PET/CT whole body imaging has higher value to laryngeal tissue involvement,neck lymph node metastasis,distant metastasis and accurate staging in patients with laryngeal carcinoma than CT plain scan and enhancement;When SUVmax was taken 3.5,¹⁸F-FDG PET/CT was the most effective in the diagnosis of primary laryngeal carcinoma and regional lymph node metastasis.2.Patients with laryngeal cancer before treatment,duration of disease,primary tumor size,SUVmax,T stage,differentiation degree,Ki-67 are related with neck lymph node metastasis,the primary tumor differentiation and Ki-67 are independent factors of metastasis to the cervical lymph nodes of patients with laryngeal cancer.