^(18)F-FDG PET/CT评估乳腺癌治疗后复发或转移的Meta分析

^(18)F-FDG PET/CT in evaluation of recurrence and metastases after treatment in breast cancer:A Meta-analysis

目的评价18 F-FDG PET/CT对乳腺癌患者综合治疗后复发或转移的诊断价值。方法计算机检索PubMed、EMBASE、Cochrane library、Web of Science、中国生物医学文献数据库、万方数字化期刊数据库和中国期刊全文数据库等,检索时间截止2013年10月,制定纳入文献的选择标准,并根据诊断性研究质量评价标准(QUADAS)评分表评价纳入文献质量。利用Metadisc 1.4和Stata 12.0软件进行数据分析,计算合并敏感度(SEN合并)、特异度(SPE合并)、阳性似然比(+LR)、阴性似然比(-LR)、诊断比值比(DOR)及95%可信区间(CI),绘制汇总受试者工作特征(SROC)曲线,并计算曲线下面积(AUC)。结果有19篇文献符合纳入(1196例患者/1696个病灶)。以患者为研究单元,15篇(923例患者)PET/CT研究的SEN合并、SPE合并及AUC合并分别为0.93[95%CI(0.90,0.95)]、0.82[95%CI(0.78,0.86)]、0.9344;以病灶为研究单元,8篇(1696病灶数)PET/CT研究的SEN合并、SPE合并及AUC合并分别为0.93[95%CI(0.92,0.95)]、0.83[95%CI(0.78,0.87)]、0.9546。结论 18F-FDG PET/CT对乳腺癌患者综合治疗后的复发或转移具有较高的敏感度和特异度。

Objective To explore the diagnostic value of ^18F-FDG PET/CT in assessment of recurrence and metastases of breast cancer after comprehensive treatment. Methods Document retrieval was conducted on PubMed, EMBASE, Cochrane Library, Web of Science and Chinese Biomedical Literature Database, etc. , the deadline of retrieve time was October 2013. Literature selection and quality evaluation criteria of eligible study were established according to quality assess-ment of diagnostic accuracy studies （QUADAS） table. Metadisc 1.4 and Stata 12.0 software were used to analyze the pooled sensitivity （SEN）, specificity （SPE）, diagnostic odds ratio （DOR）, positive likelihood ratio （＋ LR） and negative likelihood ratio （-LR） 95% with confidence interval （CI）. The area under curve （AUC） of the summary receiver-operating characteristic curve （SROC） was calculated. Results Nineteen studies involving 1196 patients and 1696 breast lesions met the inclusion criteria. Fifteen studies comprised sample size of 923 subjects for PET/CT, the pooled SEN, SPE, and pooled AUC was 0.93 （95%CI [0.90, 0.95]）, 0.82 （95%CI [0.78, 0.86]） and 0. 9344, respectively. Eight studies included lesion-based data and totaling 1696 lesions for PET/CT, the pooled SEN, SPE and pooled AUC was 0.93 （95%CI [0.92, 0.95]）, 0.83 （95%CI [,0.78, 0.87]） and 0. 9546, respectively. Conclusion ^18F-FDG PET/CT has high sensitivi-ty and specificity for diagnosis of breast recurrence and metastases of breast cancer after comprehensive treatment.