Arigoni Stephan, Ignjatovic Stefan, Sager Patrizia, Betschart Jonas, Buerge Tobias, Wachtl Josephine, Tschuor Christoph, Limani Perparim, Puhan Milo A, Lesurtel Mickael, Raptis Dimitri A, Breitenstein Stefan
Clinic for Visceral and Transplantation Surgery, Department of Surgery, University Hospital Zurich, Zurich, Switzerland.
JMIR Res Protoc. 2013 Dec 23;2(2):e60. doi: 10.2196/resprot.2890.
Patients with hepatic metastases from neuroendocrine tumors (NETs) benefit from an early diagnosis, which is crucial for the optimal therapy and management. Diagnostic procedures include morphological and functional imaging, identification of biomarkers, and biopsy.
The aim of six systematic reviews discussed in this study is to assess the predictive value of Ki67 index and other biomarkers, to compare the diagnostic accuracy of morphological and functional imaging, and to define the role of biopsy in the diagnosis and prediction of neuroendocrine tumor liver metastases.
An objective group of librarians will provide an electronic search strategy to examine the following databases: MEDLINE, EMBASE and The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Database of Abstracts of Reviews of Effects). There will be no restriction concerning language and publication date. The qualitative and quantitative synthesis of the systematic review will be conducted with randomized controlled trials (RCT), prospective and retrospective comparative cohort studies, and case-control studies. Case series will be collected in a separate database and only used for descriptive purposes.
This study is ongoing and presents a protocol of six systematic reviews to elucidate the role of histopathological and biochemical markers, biopsies of the primary tumor and the metastases as well as morphological and functional imaging modalities for the diagnosis and prediction of neuroendocrine liver metastases.
These systematic reviews will assess the value and accuracy of several diagnostic modalities in patients with NET liver metastases, and will provide a basis for the development of clinical practice guidelines.
The systematic reviews have been prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO): CRD42012002644; http://www.metaxis.com/prospero/full_doc.asp?RecordID=2644 (Archived by WebCite at http://www.webcitation.org/6LzCLd5sF), CRD42012002647; http://www.metaxis.com/prospero/full_doc.asp?RecordID=2647 (Archived by WebCite at http://www.webcitation.org/6LzCRnZnO), CRD42012002648; http://www.metaxis.com/prospero/full_doc.asp?RecordID=2648 (Archived by WebCite at http://www.webcitation.org/6LzCVeuVR), CRD42012002649; http://www.metaxis.com/prospero/full_doc.asp?RecordID=2649 (Archived by WebCite at http://www.webcitation.org/6LzCZzZWU), CRD42012002650; http://www.metaxis.com/prospero/full_doc.asp?RecordID=2650 (Archived by WebCite at http://www.webcitation.org/6LzDPhGb8), CRD42012002651; http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42012002651#.UrMglPRDuVo (Archived by WebCite at http://www.webcitation.org/6LzClCNff).
神经内分泌肿瘤(NETs)肝转移患者可从早期诊断中获益,早期诊断对最佳治疗和管理至关重要。诊断程序包括形态学和功能成像、生物标志物鉴定以及活检。
本研究中所讨论的六项系统评价的目的是评估Ki67指数和其他生物标志物的预测价值,比较形态学和功能成像的诊断准确性,并确定活检在神经内分泌肿瘤肝转移的诊断和预测中的作用。
一组专业的图书馆员将提供电子检索策略,以检索以下数据库:MEDLINE、EMBASE和考克兰图书馆(考克兰系统评价数据库、考克兰对照试验中心注册库(CENTRAL)、疗效评价文摘数据库)。对语言和出版日期不设限制。系统评价的定性和定量综合分析将采用随机对照试验(RCT)、前瞻性和回顾性比较队列研究以及病例对照研究。病例系列将收集在一个单独的数据库中,仅用于描述目的。
本研究正在进行中,提出了六项系统评价的方案,以阐明组织病理学和生化标志物、原发性肿瘤和转移灶的活检以及形态学和功能成像模式在神经内分泌肝转移的诊断和预测中的作用。
这些系统评价将评估几种诊断方式对NET肝转移患者的价值和准确性,并将为制定临床实践指南提供依据。