正电子发射体层成像/计算机断层扫描在口腔颌面部肿瘤颈部淋巴结转移中的诊断价值

Positron emission tomography/computed tomography for detecting cervical nodule metastases of oral and ma-xillofacial cancer

目的评价正电子发射体层成像/计算机断层扫描(PET/CT)在口腔颌面部肿瘤颈部淋巴结转移诊断中的价值。方法检索中国生物医学文献数据库、Medline(OVID)和EMBASE(检索时间为2010年12月13日),并采用手工检索19种中文口腔医学期刊的方法收集PET/CT对口腔颌面部肿瘤颈部淋巴结转移的诊断性试验。由2名研究者分别进行文献纳入及文献质量评价,应用MetaDisc 1.4进行Meta分析。结果共9篇文献符合纳入标准。Meta分析结果显示PET/CT对口腔颌面部肿瘤颈部淋巴结转移(以淋巴结分区为单位)的合并敏感度、合并特异度分别为0.84、0.93;诊断比值比为47.89;工作曲线下面积为0.973 8。结论 PET/CT对口腔颌面部肿瘤颈部淋巴结转移的诊断准确性很高,可以作为诊断口腔颌面部肿瘤颈部淋巴结转移的选择,但在选择时应该充分考虑其诊断费用和安全性。

Objective To evaluate the accuracy of positron emission tomography （PET）/computed tomography （CT） for detecting cervical nodule metastases of oral and maxillofacial cancer. Methods Diagnostic test accuracy studies assessing the accuracy of PET/CT in diagnosis of cervical metastases of oral and maxillofacial cancer were retrieved from the databases of CBM, Medline （OVID） and EMBASE （searched on Dec. 13th, 2010） and manual searching of 19 dental journals in Chinese. Two researchers were employed in the articles investigation independently and evaluated the quality with quality assessment of diagnostic accuracy studies （QUADAS）. Meta-analysis was done using MetaDisc 1.4. Results Nine studies met the inclusion criteria and demonstrated high methodological quality. The results of Meta-analysis showed that, when nodal level was used as unit, PET/CT had good diagnostic value in detecting the cervical nodule metastases of oral and maxillofacial cancer. Under such a condition, the pooled sensitivity was 0.84, pooled specificity 0.93, pooled diagnostic odds ratio 47.89 and area under the curve 0.973 8. Conclusion The accuracy of PET/CT for detecting cervical nodule metastases of oral and maxillofacial cancer is relatively high and it could be used as a good diagnostic tool. And special attention should be payed to its diagnostic expense and safety when considering PET/CT.