JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.
Department of Otolaryngology - Head and Neck Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Head Neck. 2022 Dec;44(12):2875-2885. doi: 10.1002/hed.27183. Epub 2022 Sep 7.
Pretreatment determination of extranodal extension (ENE) has significant clinical implications in human papillomavirus positive (HPV+) oropharyngeal squamous cell carcinoma (OPSCC). Unfortunately there is no gold-standard imaging modality for radiological assessment of ENE in HPV+ OPSCC, leading to subjective assessments and complex decision making concerning ENE. A systematic review of diagnostic test accuracy was therefore undertaken, with five databases systemically searched to evaluate the diagnostic performance of an imaging modality for detection of ENE in HPV+ OPSCC. A meta-analysis was conducted on four CT studies using a random-effects model. While a narrative synthesis was provided for the studies using PET/CT and "CT and MRI." Out of 1772 hits, six studies were included in the review. Meta-analysis on four CT studies showed CT had an overall sensitivity of 77% and specificity of 60%. PET/CT had a sensitivity of 37.5% and specificity of 97%. "CT and MRI" had a sensitivity of 62% and specificity of 78%. Further diagnostic studies involving CT, PET/CT and MRI are ultimately required.
在人乳头瘤病毒阳性（HPV+）口咽鳞状细胞癌（OPSCC）中，治疗前确定结外扩散（ENE）具有重要的临床意义。不幸的是，目前还没有用于评估 HPV+ OPSCC 中 ENE 的影像学检查的金标准，这导致了对 ENE 的主观评估和复杂决策。因此，进行了一项诊断测试准确性的系统评价，通过五个数据库进行了系统搜索，以评估一种影像学方式在检测 HPV+ OPSCC 中 ENE 方面的诊断性能。对四项 CT 研究进行了荟萃分析，采用随机效应模型。对于使用 PET/CT 和“CT 和 MRI”的研究，提供了叙述性综合。在 1772 次命中中，有 6 项研究纳入了综述。四项 CT 研究的荟萃分析显示 CT 的总体敏感性为 77%，特异性为 60%。PET/CT 的敏感性为 37.5%，特异性为 97%。“CT 和 MRI”的敏感性为 62%，特异性为 78%。最终需要进行涉及 CT、PET/CT 和 MRI 的进一步诊断研究。
