18F-FDG PET/CT对非小细胞肺癌纵隔淋巴结转移诊断价值的Meta分析

Diagnostic value of 18F-FDG PET/CT in the diagnosis of mediastinal lymph node metastasis in non-small cell lung cancer: a Meta-analysis

    摘要
  • 摘要:
    目的用Meta分析的方法评估18F-FDG PET/CT对于非小细胞肺癌（NSCLC）纵隔淋巴结转移的诊断价值。
    方法通过检索万方数据库、中国知网、维普数据库、PubMed、Embase、Cochrane Library数据库，根据相应的检索词，收集1990年至2016年的所有PET/CT对NSCLC纵隔淋巴结诊断的发表文献，通过严格的纳入排除标准进行筛选，提取纳入文献中PET/CT对NSCLC纵隔淋巴结诊断的灵敏度、特异度、阳性似然比（PLR）、阴性似然比（NLR）、诊断比值比（DOR）并进行分析。阈值效应分析采用计算曲线下面积；亚组分析采用t检验。
    结果共纳入文献22篇，患者2543例。以患者为研究对象，总灵敏度为0.66（0.62~0.69），总特异度为0.82（0.80~0.84），总PLR为3.60（2.82~4.58），总NLR为0.45（0.37~0.54），总DOR为9.12（6.15~13.52），曲线下面积为0.826。亚组分析结果显示，患有肺结核病史的与无肺结核病史的特异度差异有统计学意义（t=2.98，P < 0.05），提示肺结核病史是影响PET/CT诊断NSCLC纵隔淋巴结转移的一个重要因素。
    结论18F-FDG PET/CT是诊断NSCLC纵隔淋巴结转移的良好方法，可为NSCLC提供准确分期。

     

    Abstract:
    ObjectiveTo assess the diagnostic value of 18F-FDG PET/CT on mediastinal lymph node(MLN) metastasis in non-small cell lung cancer(NSCLC) by Meta analysis.
    MethodsPublications on MLN staging of NSCLC by PET/CT published from 1990 to 2016 were filtered and assessed according to the criteria from Wanfang, China National Knowledge Infrastructure, Vip database, PubMed, Embase, Cochrane Library database. Receiver operating characteristic curve analysis was applied and senstivity, specificity, positive likelihood ratio(PLR), negative likelihood ratio(NLR), diagnostic odds ratio(DOR) were calculated. The threshold effect analysis uses the area under the calculated curve. Subgroup analysis adopted t test.
    ResultsTwenty-two relevant literatures were enrolled (including 2543 patients). Meta analysis showed that the pooled senstivity, specificity, PLR, NLR and DOR were 0.66(0.62-0.69), 0.82(0.80-0.84), 3.60(2.82-4.58), 0.45(0.37-0.54), 9.12(6.15-13.52), respectively. Area under curve was 0.826. The results of subgroup analysis suggested that there was a statistically significant difference between the history of tuberculosis and no history of tuberculosis, and pulmonary tuberculosis was one important factor which influenced the PET/CT diagnosis of MLN metastasis in NSCLC patients.
    ConclusionPET/CT has a high accuracy for the MLN staging in NSCLC patients.

     

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