Clinical Value Of PET/CT Combined With Multifactors For The Diagnosis Of Maligancy In Patients With FUO

Aim To evaluate the clinical value of PET/CT combined with multifactors such as clinical manifestation, laboratory tests and image examinations for the diagnosis of maligancy in patients with FUO.Method The patients with FUO, who were admitted to the First Affiliated Hospital of Zhejiang University and examined by PET/CT from January1to December31,2013were collected, The paticents were divided into two groups:malignant and non-malignant groups, and their clinical manifestation, laboratory tests, image examinations (including PET/CT scan), pathological examination were analysed. Logistic regression was uesd to screen the multi-variable and build forecasting model. ROC curve was drawn based on the prediction probability, and Youden index was used to introduce an optimal cut-off point and calculate sensitivity and specificity.Result153cases were involved in this study. The most common cause of FUO was infections (34.6%), followed by noninfectious inflammatory diseases (20.3%) and malignancies (17.6%). Lymphoma was the most common malignancy.27.5%cases were undiagnosed. There was no significant difference in gender and age distribution, arthralgia, skin rash and hepatosplenomegaly between malignant and non-malignant group (p>0.05). However, the ratio of lymphadenopathy was significantly higher in malignant group (p<0.05). The white blood cell counts, hemoglobin and platelet counts were lower in malignant group compared with non-malignant group (p<0.05), and LDH, ferritin and SUVmax were higher in malignant group (p<0.05), whereas there was no statistic difference in the values of ESR and CRP between the two groups (p>0.05). It was found that lymphadenopathy, low hemoglobin and high SUVmax were independent predictive factors for diagnosis of malignancy according to logistic regression analysis. The AUROC based on the prediction probability was0.898, sensitivity and specificity was92.6%and75%respectively.Conclusion Lymphadenopathy, low hemoglobin and high SUVmax were independent predictive factors for diagnosis of malignancy. PET/CT scan had better ability to diagnose malignancy when combined with multifactors such as clinical manifestations, laboratory tests and image examinations in patients with FUO.