18F-FDG PET/CT与CT诊断胃癌淋巴结转移直接比较的系统评价

目的 采用Meta分析和直接比较方法系统评价18F-FDG PET/CT与CT对胃癌淋巴结转移的诊断价值.方法 使用计算机系统检索中国期刊全文数据库、中文科技期刊数据库、万方数据库、PubMed、Embase、The Cochrane Library,从建库至2016年11月,搜索直接比较18F-FDG PET/CT与CT诊断胃癌淋巴结转移的诊断性比较试验.用Meta-Disc1.4软件进行分析,计算两种影像学诊断方法的合并灵敏度(sensitivity,SEN)、合并特异性(specificity,SPE)、合并阳性似然比(positive likelihood ratio,+LR)、合并阴性似然比(negative likelihood ratio,-LR),诊断优势比(diagnostic OR,DOR),并绘制SROC (summary receiver operating characteristic)曲线,计算曲线下面积(area under curve,AUG).结果 最终共纳入9篇文章,Meta分析结果显示,18F-FDG PET/CT对胃癌淋巴结转移诊断的合并SEN为0.51(95％ CI =0.47～0.55),合并SPE为0.92(95％ CI =0.89 ～0.94),合并+LR为5.77(95％ CI =4.38 ～7.59),合并-LR为0.54(95％ CI =0.45 ～0.64),DOR为12.71(95％ CI =8.97～ 18.01),AUC为0.8101.CT诊断的合并SEN为0.71(95％ CI=0.67～ 0.74),合并SPE为0.82(95％ CI =0.78 ～0.84),合并+LR为3.52(95％ CI=2.52 ～4.93),合并-LR为0.37(95％CI=0.32～0.44),DOR为10.73(95％ CI =7.35 ～ 15.66),AUC为0.8176.结论 18F-FDG PET/CT显像诊断胃癌淋巴结转移的灵敏度比CT低,但其特异性较好,有更高的诊断价值,可作为胃癌淋巴结转移的临床诊断方法之一.

Direct Comparison of 18F-FDG PET/CT and CT in the Diagnosis of Lymph Node Metastasis of Gastric Cancer: A Systematic Review

Objective To compare the diagnostic value of 18F-FDG PET/CT and CT scan in patients with lymph node metastasis of gastric carcinoma by Meta analysis.Methods We performed computer retrieval of data from CNKI,CSJD,WanFang Database,PubMed,Embase,Cochrane Library November 2016.The diagnostic comparison 18F-FDG PET/CT and CT scan for lymph node metastasis of gastric carcinoma were enrolled.Meta-DiSc 1.4 software was used to analyze the pooled sensitivity (SEN),specificity (SPE)、positive likelihood ratio (+ LR),negative likelihood ratio (-LR),diagnostic OR (DOR) and area under curve (AUC)between the two different imaging agents.Results A total of nine studies were collected as inclusion criteria.Results showed 18F-FDG in diagnosis of lymph node metastasis of gastric carcinoma as:the pooled SEN was (95％ CI =0.47-0.55),SPE was 0.92(95％ CI =0.89-0.94),+ LR was 5.77(95％ CI =4.38-7.59),-LR was 0.54 (95 ％ CI =0.45-0.64),DOR was 12.71 (95 ％ CI =8.97-18.01),AUC was 0.8101.while CT in diagnosis of lymph node metastasis of gastric carcinoma showed as:the pooled SEN was (95％ CI =0.67-0.74),SPE was 0.82 (95％ CI =0.78-0.84),+ LR was 3.52 (95％ CI =2.52-4.93),-LR was 0.37 (95％ CI =0.32-0.44),DOR was 10.73 (95％ CI =7.35-15.66),AUC was 0.8176.Conclusion The sensitivity of 18F-FDG PET / CT imaging in the diagnosis of lymph node metastasis of gastric carcinoma is lower than that of CT,but its specificity is better and has higher diagnostic value,which can be used as one of clinical diagnosis methods for lymph node metastasis of gastric carcinoma.