Chien Chun-Ru, Liang Ji-An, Chen Jin-Hua, Wang Hsiao-Nin, Lin Cheng-Chieh, Chen Chih-Yi, Wang Pin-Hui, Kao Chia-Hung, Yeh Jun-Jun
Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; C.R. Chien, J.A. Liang and J.H. Chen contributed equally to this work.
Biostatistics Center and School of Public Health, Taipei Medical University, Taipei, Taiwan; C.R. Chien, J.A. Liang and J.H. Chen contributed equally to this work.
Cancer Imaging. 2013 Dec 14;13(4):458-65. doi: 10.1102/1470-7330.2013.0038.
Although low-dose computed tomography (CT) is a recommended modality for lung cancer screening in high-risk populations, the role of other modalities, such as [(18)F]fluorodeoxyglucose-positron emission tomography (PET), is unclear. We conducted a systematic review to describe the role of PET in lung cancer screening.
A systematic review was conducted by reviewing primary studies focusing on PET screening for lung cancer until July 2012. Two independent reviewers identified studies that were compatible for inclusion/exclusion criteria. The analysis was restricted to English and included studies published since 2000. A descriptive analysis was used to summarize the results, and the pooled diagnostic performance of selective PET screening was calculated by weighted average using individual sample sizes.
Among the identified studies (n = 3497), 12 studies were included for analysis. None of the studies evaluated the efficacy of primary PET screening specific to lung cancer. Eight studies focused on primary PET screening for all types of cancer; the detection rates of lung cancer were low. Four studies reported evidence of lung cancer screening programs with selective PET, in which the estimated pooled sensitivity and specificity was 83% and 91%, respectively.
The role of primary PET screening for lung cancer remains unknown. However, PET has high sensitivity and specificity as a selective screening modality. Further studies must be conducted to evaluate the use of PET or PET/computed tomography screening for high-risk populations, preferably using randomized trials or prospective registration.
Our meta-analysis indicates that PET has high sensitivity and specificity as a selective screening modality.
尽管低剂量计算机断层扫描（CT）是高危人群肺癌筛查的推荐方式，但其他方式，如[（18）F]氟脱氧葡萄糖-正电子发射断层扫描（PET）的作用尚不清楚。我们进行了一项系统评价以描述PET在肺癌筛查中的作用。
通过回顾截至2012年7月聚焦于PET肺癌筛查的原始研究进行系统评价。两名独立评审员确定符合纳入/排除标准的研究。分析仅限于英文研究且纳入2000年以来发表的研究。采用描述性分析总结结果，并使用个体样本量通过加权平均计算选择性PET筛查的汇总诊断性能。
在识别出的研究（n = 3497）中，纳入12项研究进行分析。没有研究评估特定于肺癌的原发性PET筛查的疗效。8项研究聚焦于所有类型癌症的原发性PET筛查；肺癌的检出率较低。4项研究报告了选择性PET肺癌筛查项目的证据，其中估计的汇总敏感性和特异性分别为83%和91%。
原发性PET肺癌筛查的作用仍然未知。然而，PET作为一种选择性筛查方式具有高敏感性和特异性。必须开展进一步研究以评估PET或PET/计算机断层扫描筛查在高危人群中的应用，最好采用随机试验或前瞻性注册研究。
我们的荟萃分析表明，PET作为一种选择性筛查方式具有高敏感性和特异性。
