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对比PET-CT与MRI对宫颈癌淋巴结转移诊断价值的Meta分析
作者:王彤  孙洪赞  张军 
单位:中国医科大学附属盛京医院 放射科, 辽宁 沈阳 110004
关键词:宫颈癌 淋巴结转移 正电子发射-计算机断层扫描 磁共振成像 Meta分析 
分类号:R737.33
出版年·卷·期(页码):2020·39·第六期(705-710)
摘要:

目的: 利用Meta分析系统比较正电子发射-计算机断层扫描(PET-CT)与磁共振成像(MRI)对宫颈癌淋巴结转移诊断的临床应用价值。方法: 通过检索中国知网、万方、维普、中国生物医学文献数据库和PubMed、EMBASE、Cochrane图书馆等数据库,收集PET-CT和MRI诊断宫颈癌淋巴结转移的相关文献,检索截至2020年2月。严格按照纳入及排除标准筛选文献、提取数据,采用QUADAS-2工具独立进行质量评价,应用Meta-Disc1.4和Stata 15.0软件评价异质性,计算合并敏感度(SEN)、特异性(SPE)、阳性似然比(+LR)、阴性似然比(-LR)、诊断比值比(DOR)和绘制汇总受试者工作特征曲线(SROC),计算曲线下面积(AUROC),比较验前及验后概率。结果: 最终纳入符合标准的文献11篇,合并总体效应量分别为:PET-CT的SEN值为0.65(0.60~0.69),SPE为0.93(0.91~0.94),MRI的SEN值为0.58(0.54~0.63),SPE为0.91(0.90~0.92)。PET-CT的AUC=0.824显著高于MRI AUC=0.702(P<0.05)。研究中没有明显发表偏倚,但有统计学异质性,Meta回归分析显示基于患者或转移淋巴结的分析对异质性有显著影响(P=0.04)。结论: PET-CT在宫颈癌转移淋巴结的评估中比MRI具备更高的诊断效能,可为早期宫颈癌术前评估提供有价值的参考。

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