吲哚菁绿引导下前哨淋巴结活检在乳腺癌中的诊断效能：一项Meta分析

Diagnostic Performance of Indocyanine Green-Guided Sentinel Lymph Node Biopsy in Breast Cancer: A Meta-Analysis.

作者信息

Zhang Xiaohui, Li Yan, Zhou Yidong, Mao Feng, Lin Yan, Guan Jinghong, Sun Qiang

机构信息

Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.

出版信息

PLoS One. 2016 Jun 9;11(6):e0155597. doi: 10.1371/journal.pone.0155597. eCollection 2016.

BACKGROUND

The diagnostic performance of indocyanine green (ICG) fluorescence-guided sentinel lymph node biopsy (SLNB) for the presence of metastases in breast cancer remains unclear.

OBJECTIVE

We performed a meta-analysis to investigate the diagnostic performance of ICG-guided SLNB.

METHODS

Eligible studies were identified from searches of the databases PubMed and EMBASE up to September 2015. Studies that reported the detection rate of ICG fluorescence-guided SLNB with full axillary lymph node dissection and histological or immunohistochemical examinations were included. A meta-analysis was performed to generate pooled detection rate, sensitivity, specificity, false negative rate, diagnostic odds ratio (DOR) and a summary receiver operator characteristic curve (SROC).

RESULTS

Nineteen published studies were included to generate a pooled detection rate, comprising 2594 patients. The pooled detection rate was 0.98 (95% confidence interval [CI], 0.96-0.99). Six studies finally met the criteria for meta-analysis, which yielded a pooled sensitivity of 0.92 (95% CI, 0.85-0.96), specificity 1 (95% CI, 0.97-1), and DOR 311.47 (95% CI, 84.11-1153.39). The area under the SROC was 0.9758. No publication bias was found.

CONCLUSION

ICG fluorescence-guided SLNB is viable for detection of lymph node metastases in breast cancer. Large-scale randomized multi-center trials are necessary to confirm our results.

背景

吲哚菁绿（ICG）荧光引导下前哨淋巴结活检（SLNB）对乳腺癌转移灶的诊断效能仍不明确。

目的

我们进行了一项荟萃分析，以研究ICG引导下SLNB的诊断效能。

方法

通过检索截至2015年9月的PubMed和EMBASE数据库来确定符合条件的研究。纳入报告了ICG荧光引导下SLNB联合腋窝淋巴结清扫及组织学或免疫组化检查的检出率的研究。进行荟萃分析以得出合并检出率、敏感性、特异性、假阴性率、诊断比值比（DOR）和汇总受试者工作特征曲线（SROC）。

结果

纳入19项已发表的研究以得出合并检出率，共2594例患者。合并检出率为0.98（95%置信区间[CI]，0.96 - 0.99）。最终有6项研究符合荟萃分析标准，得出合并敏感性为0.92（95%CI，0.85 - 0.96），特异性为1（95%CI，0.97 - 1），DOR为311.47（95%CI，84.11 - 1153.39）。SROC曲线下面积为0.9758。未发现发表偏倚。