核磁共振诊断直肠癌盆腔侧方淋巴结转移价值的Meta分析  

Value of Magnetic Resonance Imaging in Diagnosis of Pelvic Lateral Lymph Node Metastasis in Rectal Cancer: A Meta-analysis

作　　者：郑建清[1] 李婷婷 肖丽华[1] 黄碧芬 吴敏[1] ZHENG Jianqing;LI Tingting;XIAO Lihua;HUANG Bifen;WU Min(Department of Radiation Oncology,The Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,China;Department of Obstetrics and Gynecology,Quanzhou Medical College People’s Hospital Affiliated,Quanzhou 362000,China)

机构地区：[1]福建医科大学附属第二医院放射治疗科,泉州362000 [2]泉州医学高等专科学校附属人民医院妇产科,泉州362000

出　　处：《肿瘤防治研究》2020年第1期52-57,共6页Cancer Research on Prevention and Treatment

基　　金：福建医科大学附属第二医院苗圃基金(2017MP04)

摘　　要：目的系统评价磁共振成像(MRI)对直肠癌盆腔侧方淋巴结转移的诊断价值。方法计算机检索EMbase、PubMed、The Cochrane Library、CNKI和WanFang Data数据库,搜集磁共振诊断直肠癌盆腔侧方淋巴结转移的相关文献,检索时限均从建库至2019年3月。由两位研究者独立筛选文献、提取资料和评价偏倚风险后,采用Stata 15软件进行统计分析,计算其合并敏感度(Sen合并)、特异性(Spe合并)、诊断比值比(DOR)等,绘制汇总受试者工作特征(SROC)曲线并计算曲线下面积(AUC)。结果共纳入11个研究,包含1059例患者。Meta分析结果显示,磁共振诊断侧方淋巴结转移的合并Sen、Spe、+LR、–LR、DOR分别为0.77(95%CI:0.38~0.88)、0.77(95%CI:0.69~0.83)、3.3(95%CI:2.4~4.5)、0.3(95%CI:0.23~0.41)、11(95%CI:6~18),SROC曲线下面积为0.83(95%CI:0.80~0.86)。结论以淋巴结短径为诊断标准,MRI诊断直肠癌侧方淋巴结转移的敏感度和特异性一般;但在没有更佳的影像学筛查条件下,MRI仍然是被推荐的检查手段。Objective To evaluate the clinical value of magnetic resonance imaging(MRI)in the diagnosis of pelvic lateral lymph node metastasis in rectal cancer.Methods EMbase,PubMed,The Cochrane Library,CNKI and WanFang Data databases were searched up to March 2019 to collect relevant studies about MRI diagnosis of pelvic lateral lymph nodes in rectal cancer.Two researchers independently screened the literature,extracted the data and assessed the risk of bias,used the Stata 15 software for statistical analysis and calculated the combined sensitivity(SEN pooled),specificity(SPE pooled)and diagnostic odds ratio(DOR).A summary receiver operating characteristic(SROC)curve was plotted and the area under the curve(AUC)was calculated.Results A total of 11 studies involving 1059 patients were included.The pooled Sen,Spe,+LR,–LR and DOR were 0.77(95%CI:0.38-0.88),0.77(95%CI:0.69-0.83),3.3(95%CI:2.4-4.5),0.3(95%CI:0.23-0.41)and 11(95%CI:6-18),respectively.The AUC of SROC was 0.83(95%CI:0.80-0.86).Conclusion Taken the short diameter of lymph nodes as the diagnostic criteria,the sensitivity and specificity of MRI in the diagnosis of lateral lymph node metastasis of rectal cancer are moderate;but in the absence of better imaging screening,MRI is still the recommended means.

关 键 词：直肠癌 淋巴结转移 核磁共振 META分析 诊断性试验 

分 类 号：R735.37[医药卫生—肿瘤]