Preoperative staging of cholangiocarcinoma and biliary carcinoma using 18F-fluorodeoxyglucose positron emission tomography: a meta-analysis
Preoperative staging of cholangiocarcinoma and biliary carcinoma using 18F-fluorodeoxyglucose positron emission tomography: a meta-analysis
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DOI：
10.1136/jim-2017-000472
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发表时间：
2018-01-01
影响因子：
2.6
通讯作者：
Liu, Nai-Jen
中科院分区：
文献类型：
--
作者：
Hu, Jing-Hong;Tang, Jui-hsiang;Liu, Nai-Jen
本荟萃分析旨在确定18 F-氟脱氧葡萄糖正电子发射断层扫描（18 F-FDG-PET）在评估原发性胆管癌（CCA）和CCA伴淋巴结和远处转移中的诊断准确性。对报告使用18F-FDG-PET对CCA患者进行术前检查/分期的研究进行了文献检索。诊断OR（DOR）被用作FDG-PET/CT在预测原发性CCA、淋巴结转移和远处转移方面的诊断性能指标。合并DOR为9.34（95%CI 4.27至20.42），汇总受试者工作特征（SROC）曲线下面积为0.8643（SE=0.0362），表明在预测原发性CCA方面总体上具有良好的判别检验性能。基于原发肿瘤部位的亚组分析显示肝内CCA的诊断性能更好（DOR=54.44，95% CI 13.44 - 220.49），肝内和肝外CCA（DOR=32.96，95% CI 1.41 - 768.80）和胆囊癌（DOR=12.93，95%CI 1.97 ~ 84.80），肝外CCA（DOR=2.55，95%CI 0.71 ~ 9.20）和肝门CCA（DOR=2.75，95%CI 0.17 ~ 43.72）。10项研究中预测淋巴结转移的合并DOR为11.34（95%CI 4.79至26.80），具有中度异质性（Cochran Q=15.14，p=0.0872，I-2=40.5%）。SROC曲线下面积为0.8584（SE=0.0729）。总之，18F-FDG-PET和PET/CT在评估CCA患者的原发肿瘤、淋巴结转移和远处转移方面是准确的。
This meta-analysis was performed to determine the diagnostic accuracy of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) in assessing primary cholangiocarcinoma (CCA) and CCA with lymph node and distant metastasis. A literature search for studies reporting the use of 18F-FDG-PET for preoperative work-up/staging in patients with CCA was performed. Diagnostic OR (DOR) was used as an index of diagnostic performance of FDG-PET/CT in predicting primary CCA, lymph node metastases, and distant metastases. The pooled DOR was 9.34 (95% CI 4.27 to 20.42) and the area under the summary receiver operating characteristic (SROC) curve was 0.8643 (SE=0.0362), indicating overall good discriminatory test performance in predicting primary CCA. Subgroup analyses based on the primary tumor site showed better diagnostic performance for intrahepatic CCA (DOR=54.44, 95% CI 13.44 to 220.49), both intrahepatic and extrahepatic CCA (DOR=32.96, 95% CI 1.41 to 768.80) and gallbladder cancer (DOR=12.93, 95% CI 1.97 to 84.80), than for extrahepatic CCA (DOR=2.55, 95% CI 0.71 to 9.20) and hilar CCA (DOR=2.75, 95% CI 0.17 to 43.72). The pooled DOR for the prediction of lymph nodes metastases in 10 studies was 11.34 (95% CI 4.79 to 26.80), with moderate heterogeneity (Cochran Q=15.14, p=0.0872, I-2=40.5%). The area under the SROC curve was 0.8584 (SE=0.0729). In conclusion, 18F-FDG-PET and PET/CT were found to be accurate in the evaluation of primary tumors, lymph node metastasis, and distant metastasis in patients with CCA.