PET诊断结直肠癌复发价值及误诊原因的Meta分析

Meta-analysis on the diagnostic value of PET in recurrent coiorectal cancer and on factors inducing misdiagnosis

目的用 Meta 分析方法研究^(18)F-FDG PET 在结直肠癌复发诊断中的价值,并探讨其主要的误诊原因。方法收集2007年2月8日前公开发表的关于 PET 对结直肠癌术后复发评估的所有中英文文献,对纳入文献进行方法学质量评估后,用统计软件计算综合灵敏度(Se)、特异性(Sp)、诊断优势比(DOR),并绘制综合受试者工作特征(SROC)曲线。结果共有19篇文献纳入。PET评价结直肠癌全身复发及转移的综合 Se 为89.5%[95%可信区间(CI)86.6%～92.0%],综合 Sp为78.3%(95%CI 72.0%～83.8%),综合 DOR 为28.114(95%CI 12.120～65.216);SROC 曲线下面积为0.8857,Q~*值为0.8163。结论 ^(18)F-FDG PET 在结直肠癌术后复发诊断中有较高的价值。

Objective A meta-analysis was conducted to assess the diagnostic value of 18^F-FDG PET in recurrent colorectal cancer with concerns on the causes of misdiagnosis. Methods Nineteen publications were collected from the English and Chinese literatures on PET imaging in recurrent colorectal cancer. Methodological quality of the included studies was evaluated. Pooled sensitivity, specificity, diagnostic odds ratios （DOR） and summary receiver operating characteristic （SROC） curves were obtained by the statistical software. Results Summarized from the 19 studies in the meta-analysis, the pooled sensitivity, specificity, DOR for PET detecting recurrent colorectal cancer were 89.5% [95% confidence interval （CI） 86.6% - 92.0% ], 78.3% （95% CI 72.0% - 83.8% ） , 28.114（95% CI 12. 120 - 65. 216）, respectively. The area under the curve and Q ^＊ value in SROC were 0. 8857 and 0. 8163. Conclusion 18^F-FDG PET is valuable for the assessment of recurrent colorectal cancer.