增强CT对头颈部鳞癌患者颈部淋巴结包膜外侵犯的诊断效能:系统评价与meta分析  

Contrast-enhanced CT for the diagnosis of extracapsular spread by head and neck cancers: a systematic review and meta analysis

作　　者：唐曹敏[1,2] 乔翔鹤 李春洁 闫恺潇[1,2] 林洁 王晓毅 TANG Cao-min;QIAO Xiang-he;LI Chun-jie;YAN Kai-xiao;LIN Jie;WANG Xiao-yi(Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University. Chengdu 610041;State Key Laboratory of Oral Disease, Sichuan University. Chengdu 610041, Sichuan Province, China)

机构地区：[1]四川大学华西口腔医学院头颈肿瘤外科,四川成都610041 [2]口腔疾病国家重点实验室,四川成都610041

出　　处：《上海口腔医学》2018年第6期668-672,共5页Shanghai Journal of Stomatology

基　　金：2016年四川大学优秀青年学者基金(2082604194311);2017年四川大学青年教师科研启动基金(2017SCU11009)

摘　　要：目的:评价增强CT对头颈部鳞癌患者颈部淋巴结包膜外侵犯的诊断效能。方法:根据预先设定的检索式,对PubMed、EMBASE、中国生物医学文献数据库(Chinese Biomedical Literature Database)以及CNKI等数据库进行电子检索,并在SciencePaper Online上搜索尚未正式发表的文献,检索时间截至2017年5月15日;同时进行手工检索。2名评价者独立使用QUADAS-2,评价纳入研究的方法学质量并进行数据提取。运用MetaDisc 1.4、STATA 11.0软件进行meta分析。结果:最终纳入8篇文献,涉及患者639例。8篇均为回顾性研究,1篇有高偏倚风险,其余偏倚风险情况不清。Meta分析结果显示,增强CT在诊断淋巴结包膜外侵犯的合并敏感度为0.67,合并特异度为0.84,曲线下面积为0.83。结论:增强CT可作为头颈部鳞癌患者颈部淋巴结包膜外侵犯的确诊工具。PURPOSE:This study aimed to assess the diagnostic efficacy of contrast-enhanced CT in the screening of extracapsular spread by head and neck cancers.METHODS:Electronic databases,including MEDLINE,EMBASE,CBM,CNKI and SciencePaper Online were searched electronically.Hand-searching was also performed.QUADAS-2 was used by two independent reviewers to assess the methodological quality,and data extraction of included studies was delivered.Meta analysis was conducted via MetaDisc1.4 and STATA 11.0.RESULTS:A total of 8 studies involving 639 participants were included.All studies were retrospective,1 had high risk of bias,and the remaining had unclear risk of bias.Meta analysis showed that when screening extracapsular spread,contrast-enhanced CT had a pooled sensitivity of 0.67,pooled specificity of 0.84,area under curve of 0.83.CONCLUSIONS:Contrast-enhanced CT is a good tool for diagnosing extracapsular spread by head and neck cancers.

关 键 词：头颈癌 淋巴转移 包膜外侵犯 系统评价 诊断性试验 META分析 

分 类 号：R739.8[医药卫生—肿瘤]