^(18)F-FDG PET诊断淋巴瘤骨髓浸润的价值META分析  

Value of ^(18)F-FDG PET for Detection of Bone Marrow Infiltration in Patients Affected by Lymphoma: A Meta-Analysis

作　　者：汪太松[1] 赵晋华[1] 乔文礼[1] 

机构地区：[1]上海交通大学附属上海第一人民医院核医学科,上海200080

出　　处：《标记免疫分析与临床》2014年第5期581-584,598,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨18F-FDG PET诊断淋巴瘤骨髓浸润的价值。方法从MEDLINE和EMBASE数据库收集18F-FDG PET诊断淋巴瘤骨髓浸润方面的文献,计算18F-FDG PET诊断淋巴瘤骨髓浸润的合并灵敏度、特异性、准确性,并进行亚组分析,金标准为骨髓活检病理结果。结果共检索到27篇相关文献,其中13篇纳入分析,总病例数为587例,18F-FDG PET诊断淋巴瘤骨髓浸润的合并灵敏度和特异性分别为51%(95%CI为38%-64%)、91%(95%CI为85%-95%),合并阳性似然比为5.75(95%CI,3.48-9.48),合并阴性似然比为0.67(95%CI,0.55-0.82);分组分析提示18F-FDG PET诊断HD和病理类型为高侵袭性的NHL患者骨髓浸润的灵敏度高于病理类型为低侵袭性的NHL患者。结论18F-FDG PET在诊断淋巴瘤患者骨髓浸润上具有较高的临床价值,但尚不够完美,可以作为骨髓活检的重要辅助手段,其诊断价值与淋巴瘤的病理类型有关。Objective To evaluate the value of lSF-FDG PET for finding of bone marrow infiltration in patients with lymphoma. Methods Data on the diagnostic performance of 18F-FDG PET in bone marrow infiltration of lymphoma from MEDLINE and EMBASE database were combined quantitatively across eligible studies. The weighted summary sensitivities, specificities and accuracy were separate analyses according to various subgroups. Bone marrow biopsy （BMB） was used as the reference standard. Results Twenty-seven studies were identified, thirteen of them were eligible, which enrolled a total of 587 patients, were included in the meta-analysis. The independent random-effects weighted estimates of sensitivity and specificity against BMB were 51% （95% confidence interval [ CI], 38%-64% ） and 91% （95% CI, 85%-95% ） respectively. The weighted positive likelihood ratio （LR ＋ ） was 5.75 （95% CI, 348-9.48 ） and the negative likelihood ratio （LR - ） was 0.67 （95% CI, 0.55-0.82 ）. Subgroup analyses showed better sensitivity in patients with Hodgkin ＇ s disease and in aggressive histological types of non-Hodgkin＇ s lymphoma than in patients with less aggressive histological types. Conclusion This meta-analysis showed that 18F-FDG PET might be good, but not excellent, concordance with the results of BMB for the detection of bone marrow infiltration in patients with lymphoma, 18F-FDG PET may be complement to the results of BMB and its performance may vary with the type of lymphoma.

关 键 词：正电子计算机断层显像仪 淋巴瘤 骨髓浸润 活组织检查 

分 类 号：R733.1[医药卫生—肿瘤] R730.44[医药卫生—临床医学]