F-氟代脱氧葡萄糖 PET 在前列腺癌管理中的作用：系统评价和荟萃分析。
The role of F-fluciclovine PET in the management of prostate cancer: a systematic review and meta-analysis.
机构信息
Department of Nuclear Medicine, Pusan National University Yangsan Hospital, Yangsan, 50612, South Korea; BioMedical Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, 50612, South Korea; Department of Nuclear Medicine, College of Medicine, Pusan National University, Yangsan, 50612, South Korea.
Department of Nuclear Medicine, Pusan National University Yangsan Hospital, Yangsan, 50612, South Korea; Department of Nuclear Medicine, Kyungpook National University Medical Center and School of Medicine, Daegu, South Korea.
出版信息
Clin Radiol. 2019 Nov;74(11):886-892. doi: 10.1016/j.crad.2019.06.022. Epub 2019 Jul 26.
AIM
To investigate the diagnostic performance of F-fluciclovine positron-emission tomography (PET) or combined PET and computed tomography (PET/CT) for diagnosis of primary cancer, preoperative lymph node (LN) staging, and detection of recurrent disease of prostate cancer (PCa) through a systematic review and meta-analysis.
MATERIALS AND METHODS
The PubMed and EMBASE databases were searched from the earliest available date of indexing through 31 December 2018, for studies evaluating the diagnostic performance of F-fluciclovine PET or PET/CT for the management of PCa patients. The sensitivities, specificities, and positive and negative likelihood ratios (LR+ and LR-) across the studies were calculated and summary receiver operating characteristic curves were constructed.
RESULTS
Across 13 studies (563 patients), the pooled sensitivity for F-fluciclovine PET or PET/CT for diagnosis of primary PCa was 0.87 (95% confidence interval [CI]: 0.77-0.93) and a pooled specificity of 0.84 (95% CI: 0.68-0.93). For LN staging, the pooled sensitivity was 0.56 (95% CI: 0.37-0.74) and a pooled specificity of 0.98 (95% CI: 0.88-1.00). For detection of recurrent disease, the pooled sensitivity was 0.79 (95% CI: 0.60-0.91) and a pooled specificity of 0.69 (95% CI: 0.59-0.77). In meta-regression analysis, no definite variable was the source of the study heterogeneity.
CONCLUSION
The current meta-analysis showed the moderate sensitivity and specificity of F-fluciclovine PET or PET/CT for the diagnosis of primary cancer, preoperative LN staging, and detection of recurrent PCa. Further large multicentre studies will be necessary to substantiate the diagnostic accuracy of F-fluciclovine PET/CT for management of PCa patients.
目的
通过系统评价和荟萃分析，研究 F-氟代脱氧葡萄糖正电子发射断层扫描（PET）或联合 PET 和计算机断层扫描（PET/CT）在诊断前列腺癌（PCa）原发癌、术前淋巴结（LN）分期和检测复发性 PCa 方面的诊断性能。
材料与方法
检索了 PubMed 和 EMBASE 数据库，检索时间为最早可追溯到索引日期至 2018 年 12 月 31 日，评估 F-氟代脱氧葡萄糖 PET 或 PET/CT 对 PCa 患者管理的诊断性能的研究。计算了各研究的敏感性、特异性、阳性和阴性似然比（LR+和 LR-），并绘制了汇总受试者工作特征曲线。
结果
共有 13 项研究（563 例患者）纳入荟萃分析，F-氟代脱氧葡萄糖 PET 或 PET/CT 诊断原发 PCa 的汇总敏感性为 0.87（95%置信区间：0.77-0.93），特异性为 0.84（95%置信区间：0.68-0.93）。对于 LN 分期，汇总敏感性为 0.56（95%置信区间：0.37-0.74），特异性为 0.98（95%置信区间：0.88-1.00）。对于检测复发性疾病，汇总敏感性为 0.79（95%置信区间：0.60-0.91），特异性为 0.69（95%置信区间：0.59-0.77）。在荟萃回归分析中，没有确定的变量是研究异质性的来源。
结论
本荟萃分析表明，F-氟代脱氧葡萄糖 PET 或 PET/CT 对诊断原发癌、术前 LN 分期和检测复发性 PCa 的敏感性和特异性均为中等水平。需要进一步开展大型多中心研究来证实 F-氟代脱氧葡萄糖 PET/CT 对 PCa 患者管理的诊断准确性。
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