前哨淋巴结活检判断口腔癌颈部淋巴结转移的系统评价

A systematic review of the effect of sentinel lymph node biopsy in the detection of metastasis of oral cancer

目的:系统评价前哨淋巴结活检(SLNB)预测口腔癌颈淋巴结转移的临床价值。方法:通过计算机检索CENTRAL、Medline、EMBASE、IFCC、中国生物医学文献数据库系统(CBM)、中国期刊全文数据库(CNKI)、中文科技期刊全文数据库(CQVIP)、万方数据库等,收集应用前哨淋巴结活检判断口腔癌颈淋巴转移的诊断试验,应用统计软件Meta-DiSc 1.4进行数据分析。结果:纳入分析的文献9篇,前哨淋巴结活检判断口腔癌颈淋巴转移的敏感度、特异度、阳性似然比(+LR)、阴性似然比(-LR)、诊断优势比(DOR)及系统接收操作特性曲线(SROC)下面积分别为84%(95%CI 73%～92%)、100%(95%CI97%～100%)、19.16(95%CI 7.65～47.77)、0.22(95%CI 0.10～0.51)、97.72(95%CI 29.69～321.61)和0.99。结论:前哨淋巴结活检可作为临床上判断口腔癌颈淋巴结转移有效可行的方法。

Objective： To evaluate the diagnostic value of sentinel lymph node biopsy（SLNB） in the detection of metastasis of oral cancer by systematic review.Methods： By searching CENTRAL（the Cochrane central register of controlled trials）,Medline,EMBSE,international federation of clinical chemistry and laboratory medicine（IFCC）,China biological medical literature database system（CBM）,China Academic Journals Full-text Database（CNKI WANFANG） and DATA CQVIP Chinese Scientific Journals Fulltex Database（CQVIP） et al,all diagnostic tests about sentinel lymph node biopsy（SLNB） in oral cancer were collected.The sensitivity,specificity,diagnostic odds ratio（DOR）,and systematic receiver operating characteristic curves（SROC） were calculated to assess the diagnostic value of individual diagnostic tests.The data were analysised by using statistic software Meta-DiSc 1.4.Results： 9 trials including 187 subjects were analyzed in the systematic review.The pooled values of sensitivity,specificity,positive likelihood ratio（＋LR）,negative likelihood ratio（-LR）,DOR and SROC curve of SLN for oral cancer metastasis were 84%（95%CI 73%~92%）,100%（95%CI 97%~100%）,19.16（95%CI 7.65~47.77）,0.22（95%CI 0.10~0.51）,97.72（95%CI 29.69~321.61）and 0.99,respectively.Conclusion： SLN can be regarded as an effective and feasible method for detection of cervical lymph node metastasis of oral cancer.