PET/CT对宫颈癌淋巴结转移诊断价值的Meta分析  

Diagnostic Value of PET/CT for Metastatic Lymph Nodes in Cervical Cancer Patients: A Meta-analysis

作　　者：田金徽[1,2,3] 李金龙[4,5] 葛龙[4,5] 王婧[4,6] 张明霞[4,6] 石芳毓 王小虎[1,3] 张红[2] 

机构地区：[1]甘肃省医学科学研究院肿瘤医院,兰州730050 [2]中国科学院近代物理研究所,兰州730000 [3]甘肃省循证医学与临床转化重点实验室 [4]兰州大学基础医学院循证医学中心,兰州730000 [5]兰州大学第一临床医学院,兰州730000 [6]兰州大学第二临床医学院,兰州730000

出　　处：《肿瘤防治研究》2015年第3期270-276,共7页Cancer Research on Prevention and Treatment

摘　　要：目的采用Meta分析方法评价PET/CT在宫颈癌淋巴结转移诊断中的临床价值。方法计算机检索Pub Med、Web of Science、Cochrane Library、Embase.com、维普、万方、中国期刊全文数据库、中国生物医学文献数据库,并辅以手工检索,检索日期截止2013年7月11日,获取PET/CT诊断宫颈癌淋巴结转移的相关文献。2名研究者严格按照纳入排除标准独立地筛选文献、提取资料,依据QUADAS(quality assessment of diagnostic accuracy studies)工具进行文献质量评价,用Meta-Disc 1.4和Stata 12.0软件对其敏感度(SEN)、特异性(SPE)、阳性似然比(+LR)、阴性似然比(-LR)、诊断比值比(DOR)进行合并分析,并进行异质性检验,绘制综合受试者工作特征曲线(SROC),并计算曲线下面积(AUR)。结果检索获得1 006条记录,最终纳入26篇文献,其中英文文献23篇,中文文献3篇。Meta分析结果显示:SEN合并、SPE合并、+LR合并、-LR合并、DOR、A U R O C,验前概率和验后概率分别为0.7 3(9 5%C I:0.70~0.76)、0.96(95%CI:0.95~0.96),7.86(95%CI:5.30~11.65)、0.35(95%CI:0.28~0.45)、31.63(95%CI:17.17~58.25)、0.92(95%CI:0.89~0.94)、20%和73%。结论PET/CT对比手术后病理诊断宫颈癌淋巴结转移有中度的敏感度和较好的特异性,可作为宫颈癌淋巴结转移的诊断方法之一。Objective To evaluate the diagnostic value of PET/CT for metastatic lymph nodes in cervical cancer patients by Meta-analysis. Methods We systematically searched Pub Med, EMBASE, Cochrane Library, Embase.com, VIP, CNKI, Wangfang databases, and CBM from inception to July 11, 2013 to identify relative studies of PET/CT for metastatic lymph nodes in cervical cancer patients. Study selection and data extraction were performed by two independent reviewers, and quality assessment of diagnostic accuracy studies(QUADAS) items were used to evaluate the quality of included studies. Meta-disc 1.4 and Stata12.0 software were used to synthesize the data, such as sensitivity(SEN), specificity(SPE), positive likelihood ratio(+LR), negative likelihood ratio(-LR), diagnosis odds ration(DOR), etc., for heterogeneity test, to draw summary receiver operating characteristic(SROC) and calculate the area under the curve(AUR). Results A total of 26 studies met the eligible criteria, 23 studies for English and 3 studies for Chinese. Meta-analysis results showed that SEN, SPE, +LR,-LR, DOR, AUR, pre-test probability, and post-test probability of PET/CT for metastatic lymph nodes in patients with cervical cancer were 0.73(95%CI: 0.70-0.76), 0.96(95%CI: 0.95-0.96), 7.86(95%CI: 5.30-11.65), 0.35(95%CI: 0.28-0.45), 31.63(95%CI: 17.17-58.25), 0.92(95%CI: 0.89-0.94), 20%, and 73%, respectively. Conclusion A moderate sensitivity and higher specificity were found in PET/CT for metastatic lymph nodes in patients with cervical cancer. PET/CT could be used as one of the effective diagnostic techniques to diagnose metastatic lymph nodes from cervical cancer.

关 键 词：淋巴结转移 宫颈癌 PET/CT META分析 

分 类 号：R737.33[医药卫生—肿瘤] R730.44[医药卫生—临床医学]