氟脱氧葡萄糖和乙酸盐联合在正电子发射型计算机体层显像诊断肝细胞癌的效能:Meta分析

Efficacy of combined ^(11)C-acetate and ^(18)F-FDG positron emission tomography in diagnosis of hepatocellular carcinoma:Meta-analysis

目的通过meta分析的方法 ,系统评价^(18)F-FDG和^(11)C-Acetate正电子发射型计算机体层扫描联合诊断肝细胞癌的效能。方法使用相关检索词对Medline Pubmed和中国知识基础设施数字图书馆(CNKI)进行检索,收集近年来公开发表的相关中英文文献,并对纳入文献质量进行评分,提取纳入文献的研究数据进行meta分析。结果共有5篇文献纳入本次meta分析,其中英文4篇,中文1篇;对纳入文献进行质量评分,文献得分占总分的78.8%,两种正电子药物联合显像对肝细胞癌的显示率可达到82.9%;肿瘤直径小于2 cm、2～5 cm之间及5 cm以上的肝细胞癌FDG显示阳性率为25%、45.9%、80.9%,Acetate为79.2%、80.1%、78.7%;1、2级分化的肝细胞癌,FDG显示阳性率为48%,Acetate为73.3%;3、4级分化的肝细胞癌,FDG显示阳性率为89.5%,Acetate为86.8%;肝功能Child A级时,FDG显示肝细胞癌的阳性率为59%,Acetate为72%。结论 Acetate和FDG PET对肝细胞癌显像有重要的补充作用,二者联合能提高肝细胞癌的显像效能。

Objective To systematically evaluate the efficacy on combination of ^11C-acetate and ^11F-FDG positron emission tomography in the diagnosis of hepatocellular carcinoma through meta analysis. Methods The Engilish and Chinese literature in the recent 10 years, which were studied on the diagnosis of hepatocellular carcinoma using combination of ^11C-acetate and ^11F-FDG positron emission tomography were searched in PubMed and CNKI database. The obtained literatures with high quality were included and scored. According to incorporated study data of literatures, the meta analysis was performed. Results Five literatures were included for meta analysis. Among them, four literatures were English and one was Chinese. The quality of those literatures was achieved to 78.8% of total score. The diagnosis rate of the two positron medicine combined with imaging were in 82.9% for hepatocellular carcinoma. In the tumor size less than 2 cm,2-5 cm and more than 5cm in diameter, the FDG positive rates were in 25%,45.9% and 80.9% and acetate rates were in 79.2%, 80.1% and 78.7% respectively. In the I and II grade differentiation of hepatocellular carcinoma, the FDG positive rates was in 48% and acetate rates was in 73.3%. In the m and IV grade differentiation of hepatocellular carcinoma, the FDG positive rates was in 89.5% and acetate rates was in 86.8%. When the liver function was in Child A grade, the FDG positive rate of hepatocellular carcinoma was in 59% and acetate rates was in 72%. Conclusion The acetate and FDG have an important supplementary effects on the image of hepatocellular carcinoma. The combination of two medicine would improve the image efficacy hepatocellular carcinoma.