^(18)F-FDGPETCT对甲状腺乳头状癌颈部淋巴结转移术前评估价值的Meta分析

The efficiency of ^(18)F-fluorodeoxyglucose PET CT in cervical lymph node metastasis of thyroid papillary carcinoma preoperatively:a Meta-analysis

目的通过Meta分析的方法综合评价18F-FDGPETCT术前显像对甲状腺乳头状癌患者颈部淋巴结转移的诊断价值。方法搜索国内外数据库中公开发表的利用18F-FDGPETCT显像术前评估甲状腺乳头状癌颈部淋巴结转移的中英文文献。获得颈部淋巴结转移情况的四格表资料,根据QUADAS(quality assessment of diagnostic accuracy studies)质量评价标准评价符合纳入标准的文献的质量,用Meta分析软件(Me-ta-Disc1.4)对纳入文献汇总分析,获得汇总敏感度(Se)和特异度(Sp)及其95%可信区间(95%CI),并绘制汇总受试者工作特征曲线(SROC),计算曲线下面积(AUC)。结果共获取文献5篇(英文4篇、中文1篇),通过异质性检验,采用随机效应模型进行分析。所获得的汇总敏感度为44.80%(95%CI=39.4%～50.3%),汇总特异度为93.7%(95%CI=92.1%～95.0%),阳性似然比6.592(95%CI=3.365～12.912)、阴性似然比0.501(95%CI=0.310～0.810),诊断比值比为16.026(95%CI=3.647～70.425)。曲线下面积(AUC)为0.9696;Q指数为0.9192。结论 18F-FDGPETCT对甲状腺乳头状癌颈部淋巴结转移术前诊断的特异度较高,有利于阴性病变的排除,可为制定治疗计划提供较为可靠的指导意见。

Objective To have a systemic review of the efficiency of 18F-FDG PET CT in cervical lymph node metastasis in thyroid papillary carcinoma preoperatively.Methods A search of literature databases at home and abroad was performed,and relevant English and Chinese-language articles about diagnosing cervical lymph node metastasis in thyroid papillary carcinoma with 18 F-FDG PET CT were identified and picked out.Fourfold table data of cervical lymph node metastasis were extracted from the literatures.The quality of the articles was evaluated according to QUADAS（Quality assessment of diagnostic accuracy studies）.The Meta-analysis was done with the Meta-Disc software to calculate pooled weighted sensitivity （Se）,specificity （Sp）,positive likelihood ratio （LR ＋）,negative likelihood ratio （LR-） and DOR （diagnostic odds ratio） with 95％ confidence interval （CI）.Summary Receiver Operating Characteristic curve （SROC）was performed and the area under the curve （AUC）was calculated.Results 5 articles（4 English articles,1 Chinese articles）were included.After heterogeneity test was done,random effects model were selected.The pooled weighted sensitivity,specificity,positive likelihood ratio,negative likelihood ratio and diagnostic odds ratio（DOR） with 95％ confidence interval （95％ CI） was 0.448 （95％ CI：0.394-0.503）,0.937（95％ CI：0.921-0.950）,6.592 （95％ CI：3.365-12.912）,0.501 （95％ CI：0.310-0.810）,16.026 （95％ CI：3.647-70.425）,respectively; The AUC was 0.9696.Conclusions The specialty was high,which was more efficient in negative diagnosis,and it may guide clinical treatment.