机构地区:[1]兰州市第一人民医院耳鼻咽喉科,兰州730050 [2]兰州大学第一医院
出 处:《临床耳鼻咽喉头颈外科杂志》2018年第24期1876-1882,共7页Journal of Clinical Otorhinolaryngology Head And Neck Surgery
基 金:兰州市科技发展计划项目(No:2018-3-71)
摘 要:目的:采用Meta分析的方法评估^(18)F-FDG PET/CT和PET在结外鼻型NK/T细胞淋巴瘤(ENKTL)中诊断及分期的价值。方法:系统检索PubMed、Embase、Cochrane、Web of Science、CNKI、Wanfang、CBM和重庆维普数据库中有关^(18)F-FDG PET/CT和PET诊断ENKTL的研究,检索时间截止至2018年6月。由两位研究人员采用双盲法按照纳入、排除标准进行文献筛选和资料提取,采用QUADAS-2评价标准评价纳入研究的质量后,使用Revmann 5.3和Stata 12.0软件进行Meta汇总分析,计算_(合并)的敏感度(Sen)、特异度(Spe)、诊断比值比(DOR)及曲线下面积(AUC),以评价18 F-FDG PET/CT和PET在ENKTL中诊断及分期的价值。结果:共纳入10篇^(18)F-FDG PET/CT及4篇PET诊断ENKTL的原始研究,分别包括457例患者的5 092个病灶和169例患者的384个病灶。Meta分析显示,18 F-FDG PET/CT诊断ENKTL的Sen_(合并)=0.97(95%CI 0.93-0.99)、Spe_(合并)=0.97(95%CI0.88-0.99)、DOR_(合并)=1 131.07(95%CI167.77-7 625.28)、AUC=0.99(95%CI0.98-1.00);PET诊断ENKTL的Sen_(合并)、Spe_(合并)、DOR_(合并)、AUC分别为0.81(95%CI 0.70-0.89)、0.90(95%CI0.66-0.98)、39.63(95%CI6.41-244.85)、0.86(95%CI0.82-0.89)。通过Z检验分析结果可知,^(18)F-FDG PET/CT诊断ENKTL的诊断效能(AUC=0.99,95%CI 0.98-1.00)明显高于PET(0.86,95%CI 0.82-0.89),且差异有统计学意义(Z=2.95,P=0.003)。结论:相对于PET成像,18 F-FDG PET/CT对ENKTL诊断及分期具有极高的价值,可被视为一种ENKTL无创诊断及分期的影像学方法。Objective:The aim of this study is to comprehensively evaluate the values of 18F-FDG PET/CT and PET in diagnosing extranodal nasal type natural killer/T cell lymphoma(ENKTL).Method:Studies about ENKTL diagnosed by 18F-FDG PET/CT and PET until June 2018 were searched in the databases such as PubMed,Embase,Cochrane,Web of Science,CNKI,CBM,VIP and Wanfang.Two reviewers independently screened literature and extracted data strictly according to included and excluded criterion,and assessed bias risk by 11 items using QUADAS-2 gulidline.Meta-analysis was performed by Revmann 5.3 and Stata 12.0 software.The pooled weighted Sentivity(Sen),Specificity(Spe),Diagnostic odds ratio(DOR)were calculated,summary receiver operator curve(SROC)and area under SROC curve(AUC)were also drawn.Result:Ten studies with 457 patients and 5 092 foci on 18F-FDG PET/CT and 4 studies with 169 patients and 384 foci on PET were finally included in our Meta-analysis.Our research showed that pooled Sen,Spe,DOR and AUC of 18F-FDG PET/CT diagnosing ENKTL were 0.97(95%CI0.93-0.99),0.97(95%CI 0.88-0.99),1 131.07(95%CI 167.77-7 625.28),0.99(95%CI0.98-1.00),and they were 0.81(95%CI0.70-0.89),0.90(95%CI0.66-0.98),39.63(95%CI6.41-244.85),0.86(95%CI0.82-0.89),respectively.Ztest result reveled that 18F-FDG PET/CT had better diagnostic value in detecting ENKTL compared to PET:AUC=0.99(95%CI 0.98-1.00)vs AUC=0.86(95%CI0.82-0.89),Z=2.95,P=0.003.Conclusion:In comparasion with PET,18F-FDG PET/CT had excellent diagnostic value in detecting and staging ENKTL and may served as a non-invasive imaging in diagnosing and staging ENKTL.
关 键 词:18F-FDGPET/CT PET 结外鼻型 NK/T细胞淋巴瘤 META分析
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