CT和MRI对直肠癌术前T、N分期价值的Meta分析

CT and MRI in Preoperative TN Staging for Rectal Cancer:Meta analysis

目的比较CT和MRI对直肠癌术前T、N分期的价值。方法收集公开发表的对CT与MRI进行术前直肠癌T、N分期价值比较的国内外所有前瞻性和回顾性研究,按照Meta分析的要求对检索到的原始研究的质量进行评估,对符合条件的所有研究结果进行Meta分析,分别计算在T1～T4、N分期上,CT与MRI的灵敏度和特异度并进行比较。结果符合纳入标准的共9篇文章,总样本量347例。对于T分期,CT的灵敏度为0.772,特异度为0.880;MRI的灵敏度为0.910,特异度为0.935。对于N分期,CT的灵敏度为0.636,特异度为0.734;MRI的灵敏度为0.563,特异度为0.849。结论对于T分期,MRI在灵敏度、特异度均优于CT;对于N分期,CT灵敏度优于MRI,MRI特异度优于CT。另外,直肠癌术前放化疗能显著影响CT和MRI术前T分期的灵敏度和特异度,对于N分期,则影响不明显。

Objective To compare the efficacy of CT and MRI in preoperative TN staging for rectal cancer.MethodsProspective or retrospective studies about CT and MRI in preoperative TN staging for rectal cancer that were published in both China and overseas were collected.The quality of the studies was strictly evaluated and high quality studies were selected and analyzed by means of meta-analysis.Statistics about the sensitivity and specificity of CT and MRI in preoperative TN staging were extracted and compared respectively.Results Totally 9 studies including 347 cases were analyzed.For T staging,the sensitivity and specificity of CT and MRI were 0.772 and 0.880,and 0.910 and 0.935 respectively;while for N staging,those were 0.636 and 0.734,and 0.563 and 0.849,respectively.Conclusions MRI shows higher sensitivity and specificity then CT for T stating,but lower sensitivity and higher specificity then CT in N staging.Preoperative chemotherapy significantly influences the sensitivity and specificity of both CT and MRI for T staging,but such influence is not detectable in N staging.