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Objective:To analyze the value of maximum standardized uptake value (SUV max) of 18F-fluorodeoxyglucose (FDG) PET/CT in differentiating the malignant solitary pulmonary nodules (SPN) from benign ones. Methods:18F-FDG PET/CT imaging data of 84 patients (39 males, 45 females; age: 34-81(average: 61.1) years) with SPN in the First People′s Hospital of Lianyungang between September 2017 and June 2019 were retrospectively analyzed. The pathological results were taken as the gold standard. Differences of SUV max between benign and malignant SPN were analyzed with Mann-Whitney U test, and the best cut-off value for the diagnosis of benign and malignant SPN was measured by receiver operating characteristic (ROC) curve. The diagnostic efficacy was analyzed based on SUV max. Results:The pathological results confirmed 54 patients with malignant SPN, and 30 patients with benign SPN. SUV max of malignant group was significantly higher than that of benign group (5.48±4.08 vs 1.70(0.73, 3.33); U=443.50, P=0.001). The 84 SPN included 58 solid SPN and 26 subsolid SPN. SUV max of malignant subsolid SPN and benign ones were not significantly different ( U=56.00, P>0.05). The diagnostic value of SUV max in 58 cases of solid nodules were analyzed based on ROC curves, and the optimal cut-off value was 1.85. The corresponding diagnostic sensitivity, specificity, accuracy, negative predictive value and positive predictive value were 97.06%(33/34), 62.50%(15/24), 82.76%(48/58), 15/16, 78.57%(33/42), respectively. Conclusions:18F-FDG uptake of malignant SPN were higher than benign ones. The diagnosis of benign and malignant solid SPNs based on SUV max 1.85 has high sensitivity, negative predictive value and accuracy. SUV max has limited diagnostic value on subsolid SPN.
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Objective To investigate the clinical efficacy of CT-guided 125I seeds implantation combined with gemcitabine + cis-platinum (GP) in the treatment of unresectable non-small cell lung cancer (NSCLC).Methods From January 2013 to January 2017,62 patients with unresectable Ⅱ b-Ⅲb NSCLC were randomly divided into 2 groups.In the study group,32 patients (17 males,15 females,age (62.7± 8.9) years) underwent 125I seeds implantation combined with 4 courses of GP chemotherapy,and 30 patients (18 males,12 females,age (61.9±7.0) years) in the control group underwent concurrent radiotherapy combined with 4 courses of GP chemotherapy.The short-term effects at 3 and 6 months after treatment were compared between 2 groups,as well as the survival time.Log-rank test was used to analyze the data.Results The effective rates at 3 and 6 months after treatment in the study group and control group were statistically significant (90.62％ (29/32) vs 70.00％ (21/30),96.88％ (31/32) vs 66.67％ (20/30);x2 values:3.00 and 7.22,both P＜0.05).The median survival time of the study group and control group were 17 and 15 months (x2 =2.194,P＞0.05).The 1-year survival rates of 2 groups were 87.50％ (28/32) and 76.67％ (23/30),respectively (x2=1.24,P＞0.05),and the 2-year survival rates were 40.62％ (13/32)and 20.00％(6/30),respectively (x2=4.00,P＜0.05).Conclusions 125I seeds implantation combined with GP chemotherapy is a significant treatment for unresectable NSCLC.The short-term efficacy is better than concurrent radiotherapy combined with GP regimen.
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Objective To investigate the value of tracing thyroglobulin(Tg)in predicting metastasis of post-operative patients with differentiated thyroid carcinoma(DTC)before its first pre-ablation with 131I. Methods 106 cases with DTC, undergoing total thyroidectomy and lymphadenectomy, were assigned to 2 groups as M0 group (without metastasis)and M1 group(with metastasis). Clinical data including pre-ablation stimulated thyroglobulin (sTg)and pre-operative Tg were determined. sTg, pre-operative Tg, Tg variation(△Tg), and Tg variation rate (△Tg/pre-operative Tg)between 2 groups were compared. The ROC curve and the diagnostic critical point(DCP) were analyzed. Results sTg, Pre-operative Tg, Tg variation, and Tg variation rate were significantly higher than those of M0(all P<0.01). The corresponding areas under the ROC curve(AUC)to differentiate the two groups were 0.913,0.702,0.773,and 0.943,respectively. The best diagnostic value points(DCP)were 40.60 ng/ml and-72.5%. The sensitivity and specificity were 70. 21%, 100. 00%, and 89. 36%, 88. 13%, respectively. Conclusion The pre-ablation sTg seems to be a useful diagnostic marker for predicting metastasis before the first 131I ablation. The sTg value can be effectively corrected by the Tg variation rate,and the sensitivity and accuracy of sTg for metastasis in DTC patients can be improved,finally providing evidence for pre-ablative assessment as well as strategies of 131I therapy.