PET/CT对鼻咽癌复发或残留诊断价值的Meta分析

沈国华; 周绿漪; 贾志云; 张文杰; 王乔; 邓候富

doi:10.13201/j.issn.1001-1781.2015.01.016

PET/CT对鼻咽癌复发或残留诊断价值的Meta分析

- 四川大学华西医院核医学科(成都, 610041)
基金项目:
国家自然科学基金(No:81171456,81271532/H1801)资助

详细信息

通讯作者: 邓候富,E-mail:denghfy@126.com

中图分类号: R739.6;R445.6

收稿日期: 2014-02-25

Meta-analysis of PET/CT for diagnosis of residual/recurrent nasopharyngeal carcinoma

- Department of Unclear Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China

More Information

Corresponding author: DENG Houfu, E-mail: denghfy@126.com

Received Date: 25 February 2014

摘要

摘要: 目的:准确评价PET/CT对鼻咽癌复发或残留的诊断效能。方法:检索PubMed、EMBASE、EBSCO、Web of Science、维普、万方、CNKI和CBM等数据库,获取相关文献,时间限定在1990-01-2013-09期间。2名研究者独立筛选文献和提取数据,并根据QUADAS标准评价文献质量,通过MetaDisc软件计算出PET/CT的合并敏感性、特异性和诊断优势比,绘制SROC曲线,并进行亚组分析。结果:最终纳入26篇符合标准的文献,包括1 203例患者。PET/CT诊断鼻咽癌复发或残留的敏感性为0.92(95% CI为0.89~0.94),特异性为0.87(95% CI为0.84~0.90),诊断优势比为51.10(95%CI为34.29~76.15)。SROC曲线下面积为0.949 4,Q值为0.889 7。亚组分析:PET组和PET/CT组、前瞻性组和回顾性组,组间的敏感性、特异性和诊断优势比相比较均差异无统计学意义(均P>0.05)。结论:PET/CT在诊断鼻咽癌复发或残留方面有较高的敏感性和特异性,诊断效能较好。
- 鼻咽肿瘤 /
- 残留 /
- 复发 /
- 体层摄影术 /
- X线计算机 /
- Meta分析
Abstract: Objective: To assess the diagnostic value of 18-fluoro-2-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in detecting residual/recurrent nasopharyngeal carcinoma. Method: The literatures published between January 1990 and September 2013 were searched in PubMed, EMBASE, EBSCO, Web of Science, CBM, CNKI, VIP and Wanfang databases. Two researchers independently selected studies, extracted data and assessed the quality of included studies according to the QUADAS tool. Summary sensitivity, specificity, diagnostic odds ratios (DOR), and receiver-operating characteristic (SROC) curves were obtained using Meta-Disc software. Subgroup analysis was also conducted.Result: Twenty-six studies were included in this meta-analysis, involving 1203 patients. The pooled sensitivity, specificity and DOR were 0.92 (95%CI:0.89-0.94), 0.87 (95% CI:0.84-0.90) and 51.10 (95% CI:34.29-76.15), respectively. The area under the curve (AUC) and Q index estimate for PET/CT were 0.9494 and 0.8897, respectively. The results of subgroup analysis showed no significant differences between subgroups(P>0.05). Conclusion: In a word, 18F-FDG PET/CT performed well for diagnosis of residual/recurrent nasopharyngeal carcinoma, with relatively high sensitivity and specificity.
- nasopharyngeal carcinoma /
- residue /
- recurrence /
- tomography /
- X-ray computed /
- Meta-analysis

HTML全文

参考文献(46)

[1]	CURADO M P, EDWARDS B, SHIN H R, et al. Cancer incidence in five continents[M]. France:IARC Press, 2008:1-896.
[2]	黄昌杰, 湛永滋, 黄剑锋, 等. CerbB-2基因, COX-2基因在鼻咽癌中的表达及相关性研究[J]. 广西医学, 2009, 31(3):305-307.
[3]	FARIAS T P, DIAS F L, LIMA R A, et al. Prognostic factors and outcome for nasopharyngeal carcinoma[J]. Arch Otolaryngol, 2003, 129:794-799.
[4]	ZHENG X K, CHEN L H, WANG Q S, et al. Influence of 18F-fluorodeoxyglucose positron emission tomography on salvage treatment decision making for locally persistent nasopharyngeal carcinoma[J]. Int J Radiat Oncol Biol Phys, 2006, 65:1020-1025.
[5]	CHONG V, FAN Y F. Detection of recurrent nasopharyngeal carcinoma:MR imaging versus CT[J]. Radiology, 1997, 202:463-470.
[6]	NG S, CHANG J, KO S, et al. MRI in recurrent nasopharyngeal carcinoma[J]. Neuroradiology, 1999, 41:855-862.
[7]	KAO C H, CHANGLAI S P, CHIENG P U, et al. Detection of recurrent or persistent nasopharyngeal carcinomas after radiotherapy with 18-fluoro-2-deoxyglucose positron emission tomography and comparison with computed tomography[J]. J Clin Oncol, 1998, 16:3550-3555.
[8]	FISCHBEIN N J, AASSAR O S, CAPUTO G R, et al. Clinical utility of positron emission tomography with 18F-fluorodeoxyglucose in detecting residual/recurrent squamous cell carcinoma of the head and neck[J]. Am J Neuroradiol, 1998, 19:1189-1196.
[9]	KAO C H, SHIAU Y C, SHEN Y Y, et al. Detection of recurrent or persistent nasopharyngeal carcinomas after radiotherapy with technetium-99m methoxyisobutylisonitrile single photon emission computed tomography and computed tomography[J]. Cancer, 2002, 94:1981-1986.
[10]	WHITING P, RUTJES A W, REITSMA J B, et al. The development of QUADAS:a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews[J]. BMC Med Res Methodol, 2003, 3:25-27.
[11]	WHITING P F, WESWOOD M E, RUTJES A W, et al. Evaluation of QUADAS, a tool for the quality assessment of diagnostic accuracy studies[J]. BMC Med Res Methodol, 2006, 6:9-11.
[12]	张华, 李国文, 谢爱民, 等. PET-CT和MRI在诊断鼻咽癌放疗后复发中的价值[J]. 现代肿瘤医学, 2010,18(11):2123-2127.
[13]	肖勇, 李奕钊, 郭晓君, 等. PET/CT显像在判断鼻咽癌放疗后病灶残留或复发中的价值[J]. 广东医学, 2007, 28(7):1140-1141.
[14]	申超, 刘春雨, 姚树展. 18 F-FDG PET-CT显像在鼻咽癌治疗后随访中的应用价值[J]. 医学影像学杂志, 2007, 17(7):674-676.
[15]	庞青松, 王静, 戴东, 等. 18FDG PET-CT在鼻咽癌放疗后的应用价值[J]. 中华放射肿瘤学杂志, 2007, 16(6):411-415.
[16]	马秀梅, 叶明, 陈海燕, 等. MRI和PET-CT对放疗后鼻咽癌颅底复发的诊断价值[J]. 肿瘤学杂志, 2013, 19(3):175-178.
[17]	马美, 杜晓东. PET-CT联合EBV-DNA在预测鼻咽癌复发中的研究[J]. 中国耳鼻咽喉头颈外科, 2013, 20(1):21-23.
[18]	罗耀武,唐安戊, 朱永钳, 等. 18F-FDG PET显像诊断鼻咽癌放疗后病灶残留或复发[J]. 中华核医学杂志, 2005, 25(5):303-305.
[19]	林映如,陈应瑞,李伟雄. FDG-PET判断鼻咽癌放疗后复发的临床价值[J].实用医学杂志, 2005, 21(20):2269-2270.
[20]	黄盛才,秦朝军,马加强,等. 18F-FDG PET/CT显像在鼻咽癌治疗后随访的价值[J].广西医学,2012,34(3):287-289.
[21]	何承诚,瞿炳刚,司勇锋,等.鼻咽癌治疗后FDG PET/CT与CT诊断的对比分析[J].中华临床医师杂志(电子版),2010, 4(11):2295-2297.
[22]	YEN R F, TING L L, CHENG M F, et al. Usefulness of 201TI SPECT/CT relative to 18F-FDG PET/CT in detecting recurrent skull base nasopharyngeal carcinoma[J]. Head Neck, 2009, 31:717-724.
[23]	YEN R F, HUNG R L, PAN M H, et al. 18-fluoro-2-deoxyglucose positron emission tomography in detecting residual/recurrent nasopharyngeal carcinomas and comparison with magnetic resonance imaging[J]. Cancer, 2003, 98:283-287.
[24]	YEN R F, HONG R L, TZEN K Y, et al. Whole-body 18F-FDG PET in recurrent or metastatic nasopharyngeal carcinoma[J]. J Nucl Med, 2005, 46:770-774.
[25]	吴德华, 陈龙华. 18氟-脱氧葡萄糖PET显像对鼻咽癌放射治疗后咽旁间隙复发的诊断价值[J].第一军医大学学报,2003, 23(2):159-161.
[26]	TSAI M H, SHIAU Y C, KAO C H, et al. Detection of recurrent nasopharyngeal carcinomas with positron emission tomography using 18-fluoro-2-deoxyglucose in patients with indeterminate magnetic resonance imaging findings after radiotherapy[J]. J Cancer Res Clin Oncol, 2002,128:279-282.
[27]	TSAI M H, HUANG W S, TSAI J J, et al. Differentiating recurrent or residual nasopharyngeal carcinomas from post-radiotherapy changes with 18-fluoro-2-deoxyglucose positron emission tomography and thallium-201 single photon emission computed tomography in patients with indeterminate computed tomography findings[J]. Anticancer Res, 2003, 23:3513-3516.
[28]	PENG N, YEN S, LIU W, et al. Evaluation of the effect of radiation therapy to nasopharyngeal carcinoma by positron emission tomography with 2-[F-18]Fluoro-2-deoxy-D-glucose[J]. Clin Positron Imaging,2000,3:51-56.
[29]	NG S H, CHAN S C, YEN T C, et al. Comprehensive imaging of residual/recurrent nasopharyngeal carcinoma using whole-body MRI at 3 T compared with FDG-PET-CT[J]. Eur Radiol, 2010, 20:2229-2240.
[30]	NG S H, TUNG-CHIEH J C, CHAN S C, et al. Clinical usefulness of F-18-FDG PET in nasopharyngeal carcinoma patients with questionable MRI findings for recurrence[J]. J Nucl Med, 2004,45:1669-1676.
[31]	李卫红, 黄晓明, 曾亮,等. 脱氧葡萄糖-正电子发射断层显像在鼻咽癌诊断和放疗后肿瘤残留或复发判定中的价值[J]. 中华耳鼻咽喉头颈外科杂志,2007,42(1):65-66.
[32]	KAO C H, SHIAU Y C, SHEN Y Y, et al. Detection of recurrent or persistent nasopharyngeal carcinomas after radiotherapy with technetium-99m methoxyisobutylisonitrile single photon emission computed tomography and computed tomography-Comparison with 18-fluoro-2-deoxyglucose positron emission tomography[J]. Cancer, 2002,94:1981-1986.
[33]	何发尧, 王跃建, 余丰文. 正电子发射断层摄影术在头颈部恶性肿瘤诊断中的应用[J]. 临床耳鼻咽喉科杂志,2004,18(6):355-356.
[34]	COMORETTO M, BALESTRERI L, BORSATTI E, et al. Detection and restaging of residual and/or recurrent nasopharyngeal carcinoma after chemotherapy and radiation therapy:comparison of MR imaging and FDG PET/CT[J]. Radiology, 2008, 249:203-211.
[35]	陈应瑞, 辜梅新, 李伟雄, 等. FDG PET判断鼻咽癌放疗后鼻咽病灶残留的临床价值[J]. 癌症, 2002, 21(6):651-653.
[36]	CHAN S C, NG S H, CHANG J T C, et al. Advantages and pitfalls of F-18-fluoro-2-deoxy-D-glucose positron emission tomography in detecting locally residual or recurrent nasopharyngeal carcinoma:comparison with magnetic resonance imaging[J]. Eur J Nucl Med Mol Imaging, 2006, 33:1032-1040.
[37]	AL-AMRO A, SALEEM M, BAKHEET S, et al. The role of 18-FDG positron emission tomography (FDG-PET) in detecting post-radiotherapy loco regional relapse/residual disease in nasopharyngeal cancer[J]. J Egypt Natl Canc Inst, 2009, 21:279-285.
[38]	CHAN S C, NG S H, CHANG J T C, et al. Advantages and pitfalls of 18F-fluoro-2-deoxy-D-glucose positron emission tomography in detecting locally residual or recurrent nasopharyngeal carcinoma:comparison with magnetic resonance imaging[J]. Eur J Nucl Med Mol Imaging, 2006, 33:1032-1040.
[39]	NG S H, WAN Y L, KO S F, et al. Invited. MRI of nasopharyngeal carcinoma with emphasis on relationship to radiotherapy[J]. J Magn Reson Imaging, 1998, 8:327-336.
[40]	OLMI P, FALLAI C, COLAGRANDE S, et al. Staging and follow-up of nasopharyngeal carcinoma:magnetic resonance imaging versus computerized tomography[J]. Int J Radiat Oncol, 1995, 32:795-800.
[41]	YEN R F, HUNG R L, PAN M H, et al. 18-Fluoro-2-deoxyglucose positron emission tomography in detecting residual/recurrent nasopharyngeal carcinomas and comparison with magnetic resonance imaging[J]. Cancer, 2003, 98:283-287.
[42]	LIU T, XU W, YAN W L, et al. FDG-PET, CT, MRI for diagnosis of local residual or recurrent nasopharyngeal carcinoma, which one is the best? A systematic review[J]. Radiother Oncol, 2007, 85:327-335.
[43]	HAUTZEL H, MULLER GARTNER H W. Early changes in fluorine-18-FDG uptake during radiotherapy[J]. J Nucl Med, 1997, 38:1384-1385.
[44]	MITSUHASHI N, HAYAKAWA K, HASEGAWA M, et al. Clinical FDG-PET in diagnosis and evaluation of radiation response of patients with nasopharyngeal tumor[J]. Anticancer Res, 1998, 18:2827-2832.
[45]	BAR -SHALOMR, YEFREMOV N, GURALNIK L, et al. Clinical performance of PET/CT in evaluation of cancer:additional value for diagnostic imaging and patient management[J]. J Nucl Med, 2003, 44:1200-1209.
[46]	BEYER T, TOWNSEND D W, BRUN T, et al. A combined PET/CT scanner for clinical oncology[J]. J Nucl Med, 2000, 41:1369-1379.