^(18)F-FLT与^(18)F-FDGPET/CT诊断肺癌的Meta分析

^(18)F-FLT and ^(18)F-FDG PET/CT Scan in Diagnosing Lung Cancer: A Meta-analysis

目的评价18F-FDG与18F-FLT PET/CT对肺癌诊断的价值。资料与方法计算机检索Cochrane图书馆、Pub Med、EMbase、Medline以及中国科技期刊全文数据库、万方数据库中建库至2014年5月的文献。收集18F-FDG与18F-FLT PET/CT显像诊断肺癌的文献,并按照QUADAS质量评价标准对符合纳入标准的文献进行质量评价,采用Meta Disc软件对2种方法诊断肺癌的敏感度、特异度、诊断优势比进行合并分析和异质性检验,并绘制SROC曲线,计算曲线下面积与Q*。结果最终纳入10个研究。Meta分析结果显示,18F-FDG PET/CT诊断肺癌的合并敏感性、特异性、诊断优势比、曲线下面积和Q*分别为0.88、0.56、9.10、0.8102、0.7448;18F-FLT PET/CT诊断肺癌的合并敏感度、特异度、诊断优势比、曲线下面积和Q*分别为0.79、0.78、12.50、0.8440、0.7756。结论 18F-FDG与18F-FLT PET/CT均对肺癌有较好的诊断价值,但在诊断肺癌的特异性方面,18F-FLT较18F-FDG PET/CT更有优势。

Purpose To assess the diagnostic value of 18F-FLT and 18F-FDG PET/CT scan in patients with lung cancer. Materials and Methods Computer-based retrieval was performed on Medline, PubMed, EMbase, Wanfang data, CNKI and the Cochrane Library to search reports on diagnostic value of lung cancer with 18F-FLT and 18F-FDG PET/CT scan. The quality of included studies was evaluated according to quality assessment of diagnostic accuracy studies （QUADAS）, and MetaDisc software was adopted to conduct meta-analysis. The pooled specificity, sensitivity, and diagnostic odds ratio （DOR） were calculated. The heterogeneity was tested. The summary receiving operating characteristic （SROC） curve was drawn, and the areas under the curve （AUC） as well as Q＊ were measured. Results Ten studies were included. Meta-analysis showed pooled sensitivity was 0.88, pooled specificity was 0.56, DOR was 9.10, AUC was 0.8102, Q＊ was 0.7448 for FDG group; pooled sensitivity was 0.79, pooled specificity was 0.78, DOR was 12.50, AUC was 0.8440, Q＊ was 0.7756 for FLT group. Conclusion Both 18F-FDG and 18F-FLT have well diagnostic value for lung cancer, but the specificity of 18F-FLT is higher than that of 18F-FDG in the diagnosis of lung cancer.