C-蛋氨酸正电子发射断层扫描代谢和容积参数对脑胶质瘤的预后价值：系统评价和荟萃分析。
Prognostic Value of the Metabolic and Volumetric Parameters of C-Methionine Positron-Emission Tomography for Gliomas: A Systematic Review and Meta-Analysis.
机构信息
From the Department of Nuclear Medicine (Y.-i.K.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Nuclear Medicine (Y.-i.K., J.Y.L., S.J.J.), CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
出版信息
AJNR Am J Neuroradiol. 2018 Sep;39(9):1629-1634. doi: 10.3174/ajnr.A5707. Epub 2018 Jun 28.
BACKGROUND
Several studies have demonstrated that C-methionine positron-emission tomography provides information on prognosis.
PURPOSE
We performed a systematic review and meta-analysis of the prognostic value of the metabolic and volumetric parameters of C-methionine-PET for gliomas.
DATA SOURCES
A systematic search was performed using the following combination of keywords: "methionine," "PET," "glioma," and "prognosis."
STUDY SELECTION
The inclusion criteria were the use of C-methionine-PET as an imaging tool, studies limited to gliomas, studies including metabolic parameters (tumor-to-normal ratio) and/or volumetric parameters (metabolic tumor volume), and studies reporting survival data. The electronic search first identified 181 records, and 14 studies were selected.
DATA ANALYSIS
Event-free survival and overall survival were the outcome measures of interest. The effect of the tumor-to-normal ratio and metabolic tumor volume on survival was determined by the effect size of the hazard ratio. Hazard ratios were extracted directly from each study when provided or determined by analyzing the Kaplan-Meier curves.
DATA SYNTHESIS
The combined hazard ratios of the tumor-to-normal ratio for event-free survival was 1.74 with no significance and that of the tumor-to-normal ratio for overall survival was 2.02 with significance. The combined hazard ratio of the metabolic tumor volume for event-free survival was 2.72 with significance and that of the metabolic tumor volume for overall survival was 3.50 with significance.
LIMITATIONS
The studies selected were all retrospective, and there were only 4 studies involving the metabolic tumor volume.
CONCLUSIONS
The present meta-analysis of C-methionine-PET suggests that the tumor-to-normal ratio for overall survival and the metabolic tumor volume for event-free survival and overall survival are significant prognostic factors for patients with gliomas.
背景
多项研究表明，C-蛋氨酸正电子发射断层扫描（PET）可提供预后信息。
目的
我们对 C-蛋氨酸-PET 代谢和容积参数在脑胶质瘤中的预后价值进行了系统回顾和荟萃分析。
数据来源
采用“蛋氨酸”“PET”“脑胶质瘤”和“预后”等关键词进行系统检索。
研究选择
纳入标准为使用 C-蛋氨酸-PET 作为影像学工具，研究仅限于脑胶质瘤，研究包括代谢参数（肿瘤与正常组织比值）和/或容积参数（代谢肿瘤体积），且报告生存数据。电子检索首先确定了 181 条记录，然后选择了 14 项研究。
数据分析
无进展生存期和总生存期是感兴趣的结局指标。通过危害比的效应大小来确定肿瘤与正常组织比值和代谢肿瘤体积对生存的影响。当提供时，直接从每项研究中提取危害比；当未提供时，通过分析 Kaplan-Meier 曲线来确定。
数据综合
肿瘤与正常组织比值的无进展生存期的合并危害比为 1.74，无统计学意义；肿瘤与正常组织比值的总生存期的合并危害比为 2.02，有统计学意义。代谢肿瘤体积的无进展生存期的合并危害比为 2.72，有统计学意义；代谢肿瘤体积的总生存期的合并危害比为 3.50，有统计学意义。
局限性
所选研究均为回顾性研究，只有 4 项研究涉及代谢肿瘤体积。
结论
本 C-蛋氨酸-PET 荟萃分析表明，肿瘤与正常组织比值的总生存期和代谢肿瘤体积的无进展生存期和总生存期是脑胶质瘤患者的显著预后因素。
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