Gong Yi, Wang Qingming, Dong Li, Jia Yiping, Hua Chengge, Mi Fanglin, Li Chunjie
Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Department of Hematology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Oncotarget. 2017 Feb 21;8(8):14107-14125. doi: 10.18632/oncotarget.12959.
This study aimed to evaluate the diagnostic performance of different imaging techniques and the corresponding diagnostic criteria for preoperative detection of pelvic lymph node metastasis from gynecological carcinomas.
Six databases were systematically searched for retrieving eligible studies. Study inclusion, data extraction and risk of bias assessment were performed by 2 reviewers independently. STATA 14.0 was used to perform the meta-analysis.
Eighty eligible studies were collected. The pooled sensitivity, specificity, and area under curve (AUC) of CT, MRI and DWI were 47%, 93%, 0.7424; 50%, 95%, 0.8039 and 84%, 95%, 0.9523 respectively. As regards PET, PET-CT and US, the pooled sensitivity, specificity and AUC were 56%, 97%, 0.9592; 68%, 97%, 0.9363 and 71%, 99%, 0.9008 respectively. The summary receiver operating characteristic (SROC) curve indicated that the systematic diagnostic performances of PET, PET-CT, DWI were superior to other imaging modalities.
The present work demonstrated that DWI, PET, PET-CT were the top-priority consideration of imaging modalities for detecting metastatic pelvic lymph node in gynecological carcinoma. DWI was recommended as the first choice for metastasis exclusion and all the other imaging techniques including CT and MRI were suitable for metastasis conformation. However, for the early stage lymph node malignancy, PET or PET-CT could represent a better choice. More studies exploring the diagnostic efficacy of detailed criteria are required in the future.
本研究旨在评估不同成像技术的诊断性能以及相应的诊断标准，用于术前检测妇科恶性肿瘤盆腔淋巴结转移。
系统检索六个数据库以获取符合条件的研究。由两名审阅者独立进行研究纳入、数据提取和偏倚风险评估。使用STATA 14.0进行荟萃分析。
收集了80项符合条件的研究。CT、MRI和DWI的合并敏感度、特异度和曲线下面积（AUC）分别为47%、93%、0.7424；50%、95%、0.8039和84%、95%、0.9523。至于PET、PET-CT和US，合并敏感度、特异度和AUC分别为56%、97%、0.9592；68%、97%、0.9363和71%、99%、0.9008。汇总的受试者工作特征（SROC）曲线表明，PET、PET-CT、DWI的系统诊断性能优于其他成像方式。
目前的研究表明，DWI、PET、PET-CT是检测妇科恶性肿瘤盆腔转移淋巴结成像方式的首要考虑。推荐DWI作为排除转移的首选，所有其他成像技术包括CT和MRI都适用于转移的确认。然而，对于早期淋巴结恶性肿瘤，PET或PET-CT可能是更好的选择。未来需要更多研究探索详细标准的诊断效果。
