生长抑素受体 PET 在复发性甲状腺髓样癌患者中的检出率：系统评价和荟萃分析。
Detection rate of somatostatin receptor PET in patients with recurrent medullary thyroid carcinoma: a systematic review and a meta-analysis.
机构信息
Nuclear Medicine and PET/CT Center, Oncology Institute of Southern Switzerland, Via Ospedale 12, Zip code 6500, Bellinzona, Switzerland.
Health Technology Assessment Unit, General Directorate, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
出版信息
Hormones (Athens). 2017 Oct;16(4):362-372. doi: 10.14310/horm.2002.1756.
PURPOSE
Several articles have demonstrated the high diagnostic performance of somatostatin receptor positron emission tomography (PET) in patients with neuroendocrine tumours (NETs). On the other hand, only a few studies have evaluated the detection rate (DR) of this imaging method in recurrent medullary thyroid carcinoma (MTC). We aimed to perform a systematic review and a meta-analysis of the DR of somatostatin receptor PET or PET/CT in patients with recurrent MTC to add evidence-based data to this setting.
METHODS
A comprehensive computer literature search of studies published in PubMed/MEDLINE and the Cochrane Library Database through May 2017 and regarding somatostatin receptor PET or PET/CT in patients with recurrent MTC was carried out. DR was determined on a per patient-basis. A sub-analysis considering serum calcitonin (Ctn) values was also performed.
RESULTS
Nine studies on the diagnostic performance of somatostatin receptor PET or PET/CT in detecting recurrent MTC were discussed in the systematic review. The meta-analysis of these selected studies provided the following DR on a per patient-based analysis: 63.5% [95% confidence interval (95%CI): 49-77]. Heterogeneity among the selected studies was found. DR of somatostatin receptor PET or PET/CT increased in patients with higher serum Ctn levels (83% for Ctn >500 ng/L).
CONCLUSIONS
In patients with recurrent MTC, somatostatin receptor PET or PET/CT demonstrated a non-optimal DR which increased in patients with higher serum Ctn values. The diagnostic performance of somatostatin receptor PET or PET/CT in recurrent MTC is lower compared to that of the same imaging method in the majority of NETs.
目的
有几项研究已经证明，生长抑素受体正电子发射断层扫描（PET）在神经内分泌肿瘤（NETs）患者中的诊断性能较高。另一方面，只有少数研究评估了这种成像方法在复发性甲状腺髓样癌（MTC）中的检出率（DR）。我们旨在对复发性 MTC 患者中生长抑素受体 PET 或 PET/CT 的 DR 进行系统评价和荟萃分析，为这一领域提供循证数据。
方法
通过对 2017 年 5 月之前在 PubMed/MEDLINE 和 Cochrane 图书馆数据库中发表的研究进行全面的计算机文献检索，评估了复发性 MTC 患者中生长抑素受体 PET 或 PET/CT 的 DR。DR 是基于每位患者确定的。还进行了考虑降钙素（Ctn）值的亚分析。
结果
在系统评价中讨论了 9 项关于生长抑素受体 PET 或 PET/CT 在检测复发性 MTC 中的诊断性能的研究。对这些选定研究的荟萃分析提供了基于每位患者的分析的以下 DR：63.5%[95%置信区间（95%CI）：49-77]。选定研究之间存在异质性。在 Ctn 水平较高的患者中，生长抑素受体 PET 或 PET/CT 的 DR 增加（Ctn>500ng/L 时为 83%）。
结论
在复发性 MTC 患者中，生长抑素受体 PET 或 PET/CT 的 DR 不理想，在 Ctn 值较高的患者中增加。与大多数 NETs 中相同的成像方法相比，生长抑素受体 PET 或 PET/CT 在复发性 MTC 中的诊断性能较低。
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