Liu Bin, Gao Sujuan, Li Shuofeng
Radiological Department, Cangzhou Central Hospital, Cangzhou, PR China.
Gynecol Obstet Invest. 2017;82(3):209-222. doi: 10.1159/000456006. Epub 2017 Feb 10.
In recent times, many published papers reported the diagnostic performance of CT, MRI, positron emission tomography (PET) using 2-[18F] fluoro-2-deoxy-D-glucose (FDG) and diffusion-weighted magnetic resonance imaging (DW-MRI) for detecting the lymph nodes (LNs) metastases in patients with cervical cancer. This study is aimed at assessing and comparing the diagnostic value of those non-invasive modalities in detecting the LNs metastases in cervical cancer patients.
Studies on the non-invasive modalities for the detection of metastatic LNs were searched in PubMed, Medline, Web of Science, Cochrane Library and Embase databases. Pooled positive likelihood ratios and negative likelihood ratios, diagnostic OR, area under curve (AUC), summary receiver operating characteristics were calculated as evaluation indices.
In region- or node-based analysis, the AUC of DWI-MRI (0.92) and PET or PET/CT (0.90) were better than CT (0.83), and the difference was significant (DWI-MRI vs. CT: Z = 4.61, p < 0.001; PET or PET/CT vs. CT: Z = 3.61, p = 0.001).
Among the 4 non-invasive modalities, the PET or PET/CT has the highest specificity, and DWI-MRI has the highest sensitivity.
近年来，许多已发表的论文报道了计算机断层扫描（CT）、磁共振成像（MRI）、使用2-[18F]氟-2-脱氧-D-葡萄糖（FDG）的正电子发射断层扫描（PET）以及扩散加权磁共振成像（DW-MRI）在检测宫颈癌患者淋巴结（LN）转移方面的诊断性能。本研究旨在评估和比较这些非侵入性检查方法在检测宫颈癌患者LN转移中的诊断价值。
在PubMed、Medline、科学网、考克兰图书馆和Embase数据库中检索关于检测转移性LN的非侵入性检查方法的研究。计算合并阳性似然比和阴性似然比、诊断比值比（OR）、曲线下面积（AUC）、汇总接收器操作特征作为评估指标。
在基于区域或节点的分析中，DW-MRI的AUC（0.92）和PET或PET/CT的AUC（0.90）优于CT（0.83），差异有统计学意义（DW-MRI与CT比较：Z = 4.61，p < 0.001；PET或PET/CT与CT比较：Z = 3.61，p = 0.001）。
在这4种非侵入性检查方法中，PET或PET/CT具有最高的特异性，而DW-MRI具有最高的敏感性。
