Liu Dan, Sun Lin-Mei, Liang Jing-Hua, Song Lei, Liu Xiao-Pei
Xi'an Hospital of Traditional Chinese Medicine, Xi'an 710021, Shaanxi Province, China.
Shenzhen Traditional Chinese Medicine Anorectal Hospital, Shenzhen 518000, Guangdong Province, China.
World J Clin Cases. 2022 Jul 6;10(19):6483-6495. doi: 10.12998/wjcc.v10.i19.6483.
Colorectal cancer is one of the most common cancers worldwide with high mortality and is classified as a single entity, although colon cancer and rectal cancer have largely different diagnoses, treatments, surgical methods, and recurrence rates. ≥ 16-slice spiral computed tomography (SCT) is mostly applied to detect the local stage of colon cancer; however, its diagnostic accuracy and whether it is conducive to distinguishing between high-risk and low-risk colon cancer are unclear.
To systematically review the diagnostic accuracy of ≥ 16-slice SCT for local staging of colon cancer.
Based on the PubMed, EMBASE, Cochrane Library, and Web of Science databases, computers were used to search the literature from the establishment of the database to April 2021, and the results of the diagnostic tests on ≥ 16-slice SCT for local staging of colon cancer were collected according to the inclusion criteria. The data were then extracted and assessed on the basis of the Quality Assessment Checklist of the Institute of Economics of Canada, Reference Citation Analysis (https://www.referencecitationanalysis.com/). Afterward, a meta-analysis was performed using the statistical software Meta-disc 14.0 and Stata 15.0.
Eleven studies that provided data on 1613 subjects with computed tomography diagnostic tests were included in this study. Meta-analysis revealed that the pooled sensitivity, pooled specificity, pooled negative likelihood ratio (LR), pooled diagnostic odds ratio, and area under the fitted receiver operating characteristic (ROC) curve of ≥ 16-slice SCT for colon cancer T staging were 0.67 (95%CI: 0.65-0.70), 0.81 (95%CI: 0.80-0.83), 4.13 (95%CI: 2.66-6.41), 0.39 (95%CI: 0.31-0.49), 10.81 (95%CI: 7.33-15.94), and 0.829, respectively, while the specificity, negative LR, diagnostic odds ratio, and area under the fitted ROC curve of ≥ 16-slice SCT for N staging of colon cancer were 0.54 (95%CI: 0.49-0.59), 0.74 (95%CI: 0.70-0.77), 1.92 (95%CI: 1.36-2.70), 0.67 (95%CI: 0.51-0.87), 3.74 (95%CI: 1.76-7.94), and 0.829 respectively. The sensitivity and specificity of ≥ 16-slice SCT for colon cancer T staging were acceptable, while the sensitivity for colon cancer N staging was relatively low, though its specificity was acceptable.
≥ 16-slice SCT for local staging of colon cancer has good diagnostic value; however, the accuracy needs to be confirmed by further clinical practice.
结直肠癌是全球最常见的癌症之一，死亡率高，尽管结肠癌和直肠癌在诊断、治疗、手术方法及复发率方面存在很大差异，但仍被归为单一实体。≥16层螺旋计算机断层扫描（SCT）主要用于检测结肠癌的局部分期；然而，其诊断准确性以及是否有助于区分高危和低危结肠癌尚不清楚。
系统评价≥16层SCT对结肠癌局部分期的诊断准确性。
基于PubMed、EMBASE、Cochrane图书馆和Web of Science数据库，利用计算机检索从数据库建立至2021年4月的文献，根据纳入标准收集关于≥16层SCT对结肠癌局部分期的诊断试验结果。然后根据加拿大经济学会质量评估清单、参考文献引用分析（https://www.referencecitationanalysis.com/）对数据进行提取和评估。之后，使用统计软件Meta-disc 14.0和Stata 15.0进行荟萃分析。
本研究纳入了11项提供了1613例计算机断层扫描诊断试验受试者数据的研究。荟萃分析显示，≥16层SCT对结肠癌T分期的合并敏感度、合并特异度、合并阴性似然比（LR）、合并诊断比值比及拟合受试者工作特征（ROC）曲线下面积分别为0.67（95%CI：0.65 - 0.70）、0.81（95%CI：0.80 - 0.83）、4.13（95%CI：2.66 - 6.41）、0.39（95%CI：0.31 - 0.49）、10.81（95%CI：7.33 - 15.94）和0.829，而≥16层SCT对结肠癌N分期的特异度、阴性LR、诊断比值比及拟合ROC曲线下面积分别为0.54（95%CI：0.49 - 0.59）、0.74（95%CI：0.70 - 0.77）、1.92（95%CI：1.36 - 2.70）、0.67（95%CI：0.51 - 0.87）、3.74（95%CI：1.76 - 7.94）和0.829。≥16层SCT对结肠癌T分期的敏感度和特异度可接受，而对结肠癌N分期的敏感度相对较低，但其特异度可接受。
≥16层SCT对结肠癌局部分期具有良好的诊断价值；然而，其准确性需要通过进一步的临床实践来证实。
