摘要
目的：研究18F-FDG PET和PET/CT显像寻找原发灶的价值。方法：收集2010年3月31日前公开发表的关于18F-FDG PET或PET/CT显像用于寻找原发灶价值的中英文文献，并进行数据提取和方法学质量评估。采用Meta分析的方法计算综合灵敏度（Se）、特异性（Sp）、阳性似然比（LR+）、阴性似然比（LR-）和诊断优势比（DOR），并绘制综合受试者工作特征（SROC）曲线。结果：共有24篇文献纳入（PET显像14篇，PET/CT显像10篇）。18F-FDG PET和PET/CT显像对原发灶的正确检出率为40.86%（344/842），两者分别为37.60%（144/383）和43.57%（200/459）。检出的原发灶主要位于肺、扁桃体和胃肠道。PET显像的综合Se、Sp、LR+、LR-、DOR及相应的95%可信区间（CI）分别为88%（82%~92%）、80%（74%～85%）、3.55（2.14～5.88）、0.24（0.16～0.36）和24.94（11.36～54.78）；PET/CT显像则分别为90%（86%~94%）、84%（79%～89%）、5.19（3.48～7.74）、0.07（0.02～0.25）和80.02（20.42～313.48）。SROC曲线下面积分别为0.9074和0.8758，Q*值为0.8393和0.8063。易产生假阳性的部位主要为肺、扁桃体和口咽部，而假阴性则好发于乳腺、扁桃体、舌根和骨骼等。结论：18F-FDG PET和PET/CT显像对原发不明转移癌原发灶的检出具有较高的价值。
Abstract
Objective: To evaluate the diagnostic accuracy of 18F-FDG PET and PET/CT in the detection of primary tumors. Methods: Publications were collected from the English and Chinese literatures on PET or PET/CT imaging in detecting primary tumors of patients presenting with carcinoma of unknown primary(CUP) unidentified by conventional workup(before March 31, 2010). Systematic methods were used to identify, select, and evaluate the methodological quality of the studies. The pooled sensitivity, specificity, positive likelihood ratio(LR+), negative likelihood ratio(LR-), diagnostic odds ratio(DOR) and summary receiver operating characteristic(SROC) curves were obtained through Meta analysis. Results: 24 studies were analyzed(14 studies of PET and 10 studies of PET/CT). The detection capacity of the primary tumor of PET and PET/CT was 40.86%(344/842); 37.60%(144/383) for PET and 43.57%(200/459) for PET/CT, respectively. The primary tumors detected by PET and PET/CT mostly located in lung, tonsil and gastrointestinal tract. The pooled sensitivity, specificity, LR+, LR- and DOR of PET were 88%(82%~92%), 80%(74%～85%), 3.55(2.14～5.88), 0.24(0.16～0.36) and 24.94(11.36～54.78), respectively. As for PET/CT, there were 90%(86%~94%), 84%(79%～89%), 5.19(3.48～7.74), 0.07(0.02～0.25) and 80.02(20.42～313.48), respectively. The areas under the curve in SROC were 0.9074 and 0.8758, respectively. Q* value were 0.8393 and 0.8063, respectively. False positive was mostly seen in lung, tonsil and oropharynx. However, false negative was mostly seen in breast, tonsil, base of tongue and bone. Conclusion: 18F-FDG PET and PET/CT could be valuable imaging modalities in patients with CUP beyond what was provided from a conventional workup.
关键词
肿瘤 /
未知原发灶 /
正电子发射断层显像术 /
体层摄影术 /
螺旋计算机 /
Meta分析
Key words
Neoplasms /
unknown primary /
Positron-emission tomography /
Tomography /
spiral computed /
Meta-analysis
杨忠毅;徐俊彦;胡四龙.
18F-FDG PET和PET/CT显像对原发不明转移癌诊断价值的系统性综述和Meta分析[J]. 中国临床医学影像杂志. 2011, 22(5): 328-333
YANG Zhong-yi;XU Jun-yan;HU Si-long.
Role of 18F-FDG PET and PET/CT in detection of unknown primary tumor:a systematic review and Meta-analysis of the literature[J]. Journal of China Clinic Medical Imaging. 2011, 22(5): 328-333
中图分类号：
Ｒ73-37
R817.4
Ｒ814.42
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