Department of Oral Medicine and Radiology Kalinga Institute of Dental Sciences, Patia , Bhubaneswar, India.
Asian Pac J Cancer Prev. 2024 Aug 1;25(8):2615-2623. doi: 10.31557/APJCP.2024.25.8.2615.
To compare the diagnostic accuracy of Contrast Enhanced Computed Tomography (CECT) compared to conventional imaging modalities and histopathological investigation in cervical lymph node metastasis in adults through a novel meta- analysis.
The review protocol is registered under PROSPERO(CRD42021225704) and performed in accordance to Preferred Reporting Items for Systematic Reviews and Meta-Analysis - Diagnostic Test Accuracy (PRISMA- DTA) checklist. Databases like PubMed, Google Scholar, EBSCOhost were searched from 2000 to 2023 to identify the diagnostic potential of CECT in cervical lymph node metastasis of oral carcinoma. True-positive, false-positive, true-negative, false-negative, sensitivity, specificity values were extracted or calculated if not present for each study. Quality of selected studies was evaluated based on Quality assessment of diagnostic accuracy studies (QUADAS)- 2 tool. Meta-analysis was performed in Meta-Disc 1.4 software and Review Manager 5.3 using a bivariate model parameter for the pooled sensitivity and pooled specificity. Additional analysis was performed in terms of positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR) and summary receiver operating characteristics (SROC) with Area Under Curve (AUC) and p<0.05 as statistically significant.
Six studies were included for qualitative synthesis and as well as for meta-analysis. Two studies had high risk of bias while four studies had low risk of bias. 651 patients underwent CECT and were taken for meta-analysis. The meta-analysis revealed that CECT for diagnosing cervical lymph node metastasis had a pooled sensitivity of 71%, pooled specificity of 14% with 60% Area Under Curve (AUC). +LR of 0.84, -LR of 1.36 and DOR of 0.59.
CECT has an overall fair diagnostic ability and is a valid and reliable tool in diagnosing the target condition overcoming high reliance on master specialized capacity for their execution and understanding like other conventional imaging techniques. CECT can be concluded for secondary level of prevention for cervical node metastasis of oral carcinoma under early diagnosis and prompt treatment. However, further standardized accuracy studies are indicated to improve the overall diagnostic accuracy of CECT.
通过一项新的荟萃分析，比较对比增强计算机断层扫描（CECT）与传统成像方式和组织病理学检查在成人颈淋巴结转移中的诊断准确性。
该综述方案已在 PROSPERO（CRD42021225704）注册，并按照系统评价和荟萃分析 - 诊断测试准确性（PRISMA-DTA）检查表的要求进行。从 2000 年到 2023 年，在 PubMed、Google Scholar、EBSCOhost 等数据库中搜索以确定 CECT 在口腔癌颈淋巴结转移中的诊断潜力。如果研究中没有，则提取或计算真阳性、假阳性、真阴性、假阴性、敏感性、特异性值。根据质量评估诊断准确性研究（QUADAS）-2 工具评估所选研究的质量。使用 Meta-Disc 1.4 软件和 Review Manager 5.3 在双变量模型参数中进行荟萃分析，以获得汇总敏感性和汇总特异性。使用阳性似然比（+LR）、阴性似然比（-LR）、诊断比值比（DOR）和总结受试者工作特征（SROC）进行额外分析，并结合曲线下面积（AUC）和 p<0.05 进行统计学意义评估。
纳入了六项研究进行定性合成和荟萃分析。两项研究存在高偏倚风险，四项研究存在低偏倚风险。共有 651 名患者接受了 CECT 检查并进行了荟萃分析。荟萃分析表明，CECT 诊断颈淋巴结转移的敏感性为 71%，特异性为 14%，曲线下面积（AUC）为 60%。+LR 为 0.84，-LR 为 1.36，DOR 为 0.59。
CECT 的整体诊断能力尚可，是一种有效可靠的工具，可在执行和理解方面克服对专业能力的高度依赖，如其他传统成像技术，从而诊断目标疾病。CECT 可用于口腔癌颈淋巴结转移的二级预防，以实现早期诊断和及时治疗。然而，需要进一步的标准化准确性研究来提高 CECT 的整体诊断准确性。
