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目的:探讨n 18F-脱氧葡萄糖(FDG)PET/CT对非小细胞肺癌(NSCLC)不同密度淋巴结Nn 1、Nn 2期转移的诊断价值。n 方法:纳入2007年10月至2017年12月间北京医院118例[男68例、女50例，年龄27～87(65.4±10.8)岁]Nn 0～Nn 2期NSCLC初诊患者。患者均行术前n 18F-FDG PET/CT检查，检查后1个月内行肺癌切除并局部淋巴结清扫手术。将显像结果和清除术切除的肺门纵隔淋巴结病理结果进行对比，计算并比较不同密度(钙化、部分钙化、高密度、低＋等密度)组淋巴结的转移构成比。以受试者工作特征(ROC)曲线分别获得诊断不同密度淋巴结Nn 1、Nn 2期转移的淋巴结短径和最大标准摄取值(SUVn max)界值，并计算诊断效能。采用两独立样本n t检验、Mann-Whitney n U检验及n χ2检验(n χ2分割)行统计学比较。n 结果:获得病理结果的433枚肺门纵隔淋巴结中，Nn 0期365枚，Nn 1、Nn 2期淋巴结68枚。钙化组(n n＝8)Nn 1、Nn 2期转移构成比为0，部分钙化组、低＋等密度组的转移淋巴结构成比分别为28.6%(8/28)、20.3%(44/217)，均高于高密度淋巴结组[8.9%(16/180), n χ2值：7.369、9.945，均n P0.017)。Nn 1、Nn 2期淋巴结的SUVn max高于Nn 0期淋巴结[6.94(4.51，11.36)与2.45(1.93，3.42)；n z＝-10.388，n P<0.01]。ROC曲线分析示，肺门纵隔淋巴结Nn 1、Nn 2期转移的SUVn max诊断界值为3.66，灵敏度、特异性、准确性分别为85.3%、78.9%、80.0%；低＋等密度组、高密度组的SUVn max诊断界值分别为3.66、2.79，对应的灵敏度、特异性、准确性、阳性预测值分别为93.2%、86.7%、88.0%、64.1%和93.8%、57.9%、61.1%、17.9%，除灵敏度外，其余3个指标差异有统计学意义(n χ2值：10.724、7.326、32.971，均n P<0.01)。将淋巴结短径(短径界值1.0 cm)与SUVn max联合后，低＋等密度组的特异性(94.2%)高于单纯应用短径(80.9%)或SUVn max的特异性(86.7%; n χ2值：14.048、5.661，均n P<0.05)；高密度组特异性及准确性均高于单纯应用SUVn max的结果(n χ2值：58.043、37.037，均n P<0.01)。n 结论:18F-FDG PET/CT对NSCLC低＋等密度淋巴结Nn 1、Nn 2期转移有很好的诊断价值，但对部分钙化淋巴结转移诊断价值有限。将淋巴结短径与SUVn max界值进行联合可提高n 18F-FDG PET/CT对低＋等密度、高密度淋巴结转移的诊断特异性或准确性。n “,”Objective:To investigate the diagnostic value of n 18F-fluorodeoxyglucose (FDG) PET/CT in detecting Nn 1 or Nn 2 metastasis of lymph node (LN) with different densities in patients with non-small cell lung cancer (NSCLC).n Methods:A total of 118 patients (68 males, 50 females, age range: 27-87 (65.4±10.8) years) with Nn 0-Nn 2 Mn 0 NSCLC in Beijing Hospital between October 2007 and December 2017 were included in this study. All patients underwent n 18F-FDG PET/CT, followed by surgery within 1 month. The pathological findings of the resected hilar mediastinal LN were taken as the gold standard, and ratios of LN metastasis were calculated for different density groups (calcification, partial calcification, hyper density, hypodensity/isodensity). The cut-off values of LN size (short diameter) and the maximum standardized uptake value (SUVn max) in the detection of Nn 1 and Nn 2 metastases was determined by the receiver operating characteristic (ROC) curve, and the diagnostic efficiencies were calculated. Independent-sample n t test, Mann-Whitney n U test and n χ2 test (partition of n χ2) were used for data analysis.n Results:A total of 433 LN has the histopathologic results: 365 LN was in stage Nn 0, 68 LN was in stage Nn 1-Nn 2. There were no metastases in calcification group (0/8). The metastatic LN proportions in partial calcification group (28.6%, 8/28), hypodensity/isodensity group (20.3%, 44/217) were significantly higher than that in the hyper density group (8.9%, 16/180; n χ2 values: 7.369, 9.945, both n P0.017). The SUVn max of Nn 1+ Nn 2 group was significantly higher than that in Nn 0 group (6.94 (4.51, 11.36) n vs 2.45 (1.93, 3.42); n z=-10.388, n P<0.01). According to the ROC curve, the cut-off value of SUVn max in detecting hilar and mediastinal LN was 3.66. The diagnostic sensitivity, specificity and accuracy for Nn 1+ Nn 2 metastasis was 85.3%, 78.9%, 80.0% respectively. The cut-off values of SUVn max for hypodensity/isodensity group and hyper density group were 3.66 and 2.79 respectively, and the corresponding sensitivities, specificities, accuracies and positive predictive values (PPV) were 93.2%, 86.7%, 88.0%, 64.1% n vs 93.8%, 57.9% (n χ2=10.724), 61.1% (n χ2=7.326, n P<0.01), 17.9%(n χ2=32.971, n P<0.01). The specificity of LN size (1.0 cm)+ SUVn max was significantly higher that of LN size or SUVn max alone (94.2% n vs 80.9%, 86.7%; n χ2 values: 14.048, 5.661, both n P<0.05) in hypodensity/isodensity group. The specificity and accuracy of LN size (1.0 cm)+ SUVn max were significantly higher those of SUVn max alone (n χ2 values: 58.043, 37.037, both n P<0.01) in hyper density group.n Conclusions:18F-FDG PET/CT is useful in diagnosing the Nn 1+ Nn 2 metastases in hypodensity/isodensity LN, but has limitation in diagnosing the partial calcification LN. Combination of lymph node short diameter and SUVn max cut-off value can improve the diagnostic specificity or accuracy of n 18F-FDG PET/CT for hypodensity/isodensity and high density LN.n