氟-18-氟代脱氧葡萄糖正电子发射断层扫描在 Merkel 细胞癌患者中的诊断性能：系统评价和荟萃分析。
Diagnostic performance of fluorine-18-fluorodeoxyglucose positron emission tomography in patients with Merkel cell carcinoma: a systematic review and meta-analysis.
出版信息
Am J Clin Dermatol. 2013 Dec;14(6):437-47. doi: 10.1007/s40257-013-0040-x.
BACKGROUND
Some studies reported the usefulness of fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) and PET/computed tomography (CT) in patients with Merkel cell carcinoma (MCC).
OBJECTIVE
The aim of this study was to systematically review and meta-analyze published data about the diagnostic performance of 18F-FDG PET and PET/CT in patients with MCC.
METHODS
A comprehensive literature search of studies published through June 2013 regarding 18F-FDG PET and PET/CT in patients with MCC was performed. All retrieved studies were reviewed and qualitatively analyzed. Pooled sensitivity, specificity, positive and negative likelihood ratio (LR+ and LR−) and diagnostic odds ratio (DOR) of 18F-FDG PET or PET/CT in patients with MCC on a per examination-based analysis were calculated. The area under the summary receiver operating characteristic (ROC) curve was calculated to measure the accuracy of 18F-FDG PET or PET/CT in these patients.
RESULTS
Ten studies comprising 329 patients (549 scans) with MCC were included in the qualitative analysis (systematic review) and discussed. The quantitative analysis (meta-analysis) of six selected studies (including 92 patients with MCC) provided the following results on a per examination-based analysis: sensitivity was 90 % (95 % CI 80–96), specificity 98 % (95 % CI 90–100), LR+ 12 (95 % CI 4.3–33.0), LR− 0.15 (95 % CI 0.08–0.28), and DOR 86.8 (95 % CI 23–327). The area under the summary ROC curve was 0.96. No significant statistical heterogeneity between the studies was found.
CONCLUSIONS
In patients with MCC, 18F-FDG PET or PET/CT demonstrated high sensitivity and specificity, being accurate methods in this setting. Nevertheless, the literature focusing on the use of PET and PET/CT in MCC still remains limited. Prospective studies are needed to substantiate the high diagnostic accuracy of these methods in MCC.
背景
一些研究报告称氟-18-氟代脱氧葡萄糖（18F-FDG）正电子发射断层扫描（PET）和 PET/计算机断层扫描（CT）在 Merkel 细胞癌（MCC）患者中有一定的作用。
目的
本研究旨在系统回顾和荟萃分析关于 18F-FDG PET 和 PET/CT 在 Merkel 细胞癌患者中的诊断性能的已发表数据。
方法
通过 2013 年 6 月之前对有关 18F-FDG PET 和 PET/CT 在 Merkel 细胞癌患者中的研究进行全面文献检索，对所有检索到的研究进行回顾和定性分析。基于每次检查的基础分析，计算 Merkel 细胞癌患者 18F-FDG PET 或 PET/CT 的汇总敏感性、特异性、阳性和阴性似然比（LR+和 LR−）和诊断比值比（DOR）。计算汇总受试者工作特征（ROC）曲线下面积以衡量 18F-FDG PET 或 PET/CT 在这些患者中的准确性。
结果
10 项研究共纳入 329 例（549 次扫描）MCC 患者，纳入定性分析（系统评价）和讨论。基于 6 项选定研究（包括 92 例 MCC 患者）的定量分析（荟萃分析）结果如下：基于每次检查的基础分析，敏感性为 90%（95%CI80–96），特异性为 98%（95%CI90–100），LR+为 12（95%CI4.3–33.0），LR−为 0.15（95%CI0.08–0.28），DOR 为 86.8（95%CI23–327）。汇总 ROC 曲线下面积为 0.96。各研究间无统计学异质性。
结论
在 Merkel 细胞癌患者中，18F-FDG PET 或 PET/CT 具有较高的敏感性和特异性，是该人群中的准确方法。然而，关于 PET 和 PET/CT 在 Merkel 细胞癌中的应用的文献仍然有限。需要前瞻性研究来证实这些方法在 Merkel 细胞癌中的高诊断准确性。
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