摘要
目的:系统评价PET/CT对比MRI用于诊断宫颈癌盆腔淋巴结转移的价值。方法:计算机检索Cochrane Library、Web of Science、PubMed、EMBASE等数据库,搜集关于PET/CT和MRI诊断宫颈癌盆腔淋巴结转移的试验,检索时限从建库至2020年6月。由2位研究人员负责文献筛选、资料提取和偏倚风险评价。采用STATA 16.0软件进行Meta分析,主要效应指标包括敏感度、特异度、诊断比值比及SROC曲线下面积(AUC)等。结果:共纳入7个研究,包括507例Ⅰ/Ⅱ期宫颈癌患者。Meta分析结果显示:PET/CT诊断宫颈癌淋巴结转移的合并效应值敏感性、特异性、阳性似然比、阴性似然比、诊断比值比分别为0.50 [95%(0.30, 0.69)]、 0.92 [95%(0.82, 0.96)]、 6.00 [95%(2.20, 16.4)]、 0.55 [95%(0.35, 0.85)]、 11 [95%(3, 43)]。而MRI分别为0.49 [95%(0.38, 0.60)]、 0.93 [95%(0.83, 0.97)]、 6.70 [95%(3.30,13.5)]、0.55 [95%(0.46,0.65)]、12 [95%(6,24)]。结论:PET/CT诊断宫颈癌淋巴结转移的特异性与MRI相似,但单用PET/CT或MRI均存在较高的漏诊率,需要联合其他检查手段来提高敏感性。PET/CT或MRI的诊断性能孰优孰劣,还需要进一步开展大样本前瞻性研究证实。
Objective:To evaluate the value of PET/CT and MRI in the diagnosis of pelvic lymph node metastasis in patients with cervical cancer.Methods:Cochrane Library,Web of Science,PubMed,EMBASE databases were searched up from the estab⁃lishment to June 2020 to collect relevant prospective diagnostic accuracy studies for PET/CT and MRI diagnosis of lymph nodes metastasis in cervical cancer.Two researchers were responsible for literature screening,data extraction and bias risk assessment.Meta analysis was performed by STATA16.0 software.The main effect indexes included sensitivity,specificity,diagnostic odds ratio and area under SROC curve(AUC)were diagnosed.Results:There were a total of 7 studies,including 507 patients.Meta-analysis showed that the pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,DOR for PET/CT were 0.50(95%[0.30,0.69]),0.92(95%[0.82,0.96]),6.00(95%[2.20,16.4]),0.55(95%[0.35,0.85]),11(95%[3,43]),respectively.While those fro MRI were 0.49(95%[0.38,0.60]),0.93(95%[0.83,0.97]),6.70(95%[3.30,13.5]),0.55(95%[0.46,0.65]),12(95%[6,24]).Conclusion:The specificity of PET/CT in the diagnosis of cervical cancer lymph node metastasis is similar to that of MRI,but both PET/CT and MRI has a higher missed diagnosis rate when uesd alone,and other examination methods are needed to improve sensitivity.The diagnostic performance of PET/CT or MRI needs to be confirmed by further large-scale prospective studies.
作者
黄碧芬
郑建清
ZHENG Jian-qing;HUANG Bi-fen(Department of Radiation Oncology,The Second Affiliated Hospital of Fuji-an Medical University,Quanzhou,Fujian,362000,China)
出处
《黑龙江医学》
2022年第3期306-308,312,共4页
Heilongjiang Medical Journal
基金
福建省卫生健康青年科研课题(2019-1-50)
福建省中青年教师教育科研项目(JAT190223)。
