^(99)Tc^(m)-硫胶体在乳腺癌前哨淋巴结活检中应用价值的Meta分析  

The Application Value of ^(99)Tc^(m)-sulfur Colloid in Sentinel LymphNode Biopsy of Breast Cancer:a Meta-analysis

作　　者：孙钰林 徐晓敏 高菲 姚焱 SUN Yulin;XU Xiaomin;GAO Fei;YAO Yan(CAEA Center of Excellence on Nuclear Technology Application for Engineering and Industrialization of Radiopharmaceuticals,China National Nuclear Corporation Engineering Research Center of Radiopharmaceuticals,HTA Co.,Ltd.,Beijing 102413,China)

机构地区：[1]国家原子能机构核技术(放射性药物工程转化)研发中心,中核集团放射性药物工程技术研究中心,原子高科股份有限公司,北京102413

出　　处：《标记免疫分析与临床》2024年第11期1987-1996,共10页Labeled Immunoassays and Clinical Medicine

摘　　要：目的评价^(99)Tc^(m)-硫胶体用于乳腺癌前哨淋巴结活检的有效性。方法检索PubMed、Embase、知网、万方医学、维普数据库中公开发表的乳腺癌SLNB中使用^(99)Tc^(m)-硫胶体为示踪剂的研究文献,检索时间均为自建库至2023年12月,由两名研究者独立筛选文献、提取数据及评价文献质量,采用R语言4.1.3软件对数据进行Meta分析,用漏斗图评价发表偏倚。结果入选18篇文献,纳入1926例患者。Meta分析结果显示,^(99)Tc^(m)-硫胶体的前哨淋巴结检出率、灵敏度、特异性、假阴性率分别为97.88%(95%CI 0.9663~0.9868)、84.19%(95%CI 0.6752~0.9317)、97.80%(95%CI 0.9164~0.9945)、8.32%(95%CI 0.0377~0.1736)。亚组分析结果显示,^(99)Tc^(m)-硫胶体皮内注射的检出率98.74%(95%CI 0.9768~0.9932),皮下注射检出率为96.83%(95%CI 0.9566~0.9770),皮内注射方式相较于皮下注射的检出率更高。采用18篇文献报道的前哨淋巴结检出率进行发表偏倚评价,漏斗图显示发表偏倚的可能性较小。结论^(99)Tc^(m)-硫胶体示踪法在乳腺癌SLNB中具有较高的临床应用价值。Objective To evaluate the effectiveness of ^(99)Tc^(m)-sulfur colloid injection in locating sentinel lymph node in breast cancer patients.Methods We searched PubMed,Embase,CNKI,Wanfang and VIP databases form the inception to December,2023 for the studies related with the use of ^(99)Tc^(m)-sulfur colloid injection as a tracer for SLNs in SLNB of breast cancer.Two investigators screened literature,extracted relevant data and assessed the quality of the literatures independently.The meta-analysis was performed using R 4.1.3 software.The publication bias was assessed by the funnel plot.Results A total of 18 studies were included for the final analysis,consisting of 1,926 breast cancer patients.The result of the meta-analysis showed that ^(99)Tc^(m)-sulfur colloid in SLNs had the detection rate 97.88%(95%CI 0.9663-0.9868),sensitivity 84.19%(95%CI 0.6752-0.9317),specificity 97.80%(95%CI 0.9164-0.9945),and the false negative rate 8.32%(95%CI 0.0377-0.1736).The subgroup analysis showed that the detection rate of ^(99)Tc^(m)-sulfur colloid for intradermal injection was 98.74%(95%CI 0.9768-0.9932),which was higher than subcutaneous injection 96.83%(95%CI 0.9566-0.9770).The detection rates of SLNs reported in the 18 articles were used to assess publication bias,and the funnel plot showed that a low possibility of publication bias.Conclusion The tracer method of ^(99)Tc^(m)-sulfur colloid could have a high clinical value in SLNB of breast cancer.

关 键 词：乳腺癌 前哨淋巴结活检 放射性同位素 ^(99)Tc^(m)-硫胶体 META分析 

分 类 号：R737.9[医药卫生—肿瘤]