Can (18)F-FDG PET/CT predict EGFR status in patients with non-small cell lung cancer? A systematic review and meta-analysis.
Can (18)F-FDG PET/CT predict EGFR status in patients with non-small cell lung cancer? A systematic review and meta-analysis.
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DOI：
10.1136/bmjopen-2020-044313
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发表时间：
2021-06-08
期刊：
影响因子：
2.9
通讯作者：
Li Y
中科院分区：
文献类型：
--
作者：
Du B;Wang S;Cui Y;Liu G;Li X;Li Y
本研究旨在探讨18F-脱氧葡萄糖(18F-FDG)正电子发射断层扫描(PET/CT)对非小细胞肺癌(NSCLC)患者表皮生长因子受体(EGFR)突变的诊断价值。系统综述和荟萃分析。检索PubMed、EMBASE和Cochrane图书馆数据库，从可获得的最早日期到2020年12月。该综述包括初步研究，比较野生型和突变型EGFR的平均标准摄取值最大值(SUVmax)，并评价18F-FDG PET/CT对预测非小细胞肺癌患者EGFR状态的诊断价值。主要分析评价SUVmax预测表皮生长因子受体突变的敏感性和特异度、阳性诊断似然比、阳性诊断似然比和−。摘要接收者操作员特征(SROC)图的每个数据点都来自单独的研究。使用随机效应模型对数据进行统计分析，然后进一步评估预测的诊断性能。在15项研究(3574名患者)中，18F-FDG PET/CT的合并敏感性为0.70(95%CI为0.60至0.79)，合并特异性为0.59(95%CI为0.52至0.66)。DLR+为1.74(95%CI为1.49~2.03)，DLR−为0.50(95%CI为0.38~0.65)。合并DOR为3.50(95%可信区间为2.37~5.17)。SROC曲线下面积为0.68(95%CI为0.64~0.72)。基于平均敏感度和特异度的似然比散点图位于右下象限。Meta分析结果显示，18F-FDGPET/CT的联合敏感性和特异性较低。较低的DOR和似然比散点图表明，在预测非小细胞肺癌患者的EGFR突变时，18F-FDGPET/CT应谨慎使用。
This study aimed to explore the diagnostic significance of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT for predicting the presence of epidermal growth factor receptor (EGFR) mutations in patients with non-small cell lung cancer (NSCLC). A systematic review and meta-analysis. The PubMed, EMBASE and Cochrane library databases were searched from the earliest available date to December 2020. The review included primary studies that compared the mean maximum of standard uptake value (SUVmax) between wild-type and mutant EGFR, and evaluated the diagnostic value of 18F-FDG PET/CT using SUVmax for prediction of EGFR status in patients with NSCLC. The main analysis was to assess the sensitivity and specificity, the positive diagnostic likelihood ratio (DLR+) and DLR−, as well as the diagnostic OR (DOR) of SUVmax in prediction of EGFR mutations. Each data point of the summary receiver operator characteristic (SROC) graph was derived from a separate study. A random effects model was used for statistical analysis of the data, and then diagnostic performance for prediction was further assessed. Across 15 studies (3574 patients), the pooled sensitivity for 18F-FDG PET/CT was 0.70 (95% CI 0.60 to 0.79) with a pooled specificity of 0.59 (95% CI 0.52 to 0.66). The overall DLR+ was 1.74 (95% CI 1.49 to 2.03) and DLR− was 0.50 (95% CI 0.38 to 0.65). The pooled DOR was 3.50 (95% CI 2.37 to 5.17). The area under the SROC curve was 0.68 (95% CI 0.64 to 0.72). The likelihood ratio scatter plot based on average sensitivity and specificity was in the lower right quadrant. Meta-analysis results showed 18F-FDG PET/CT had low pooled sensitivity and specificity. The low DOR and the likelihood ratio scatter plot indicated that 18F-FDG PET/CT should be used with caution when predicting EGFR mutations in patients with NSCLC.
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