<sup>18</sup>F-FDG PET/CT和PET对结外鼻型NK/T细胞淋巴瘤诊断及分期价值的Meta分析

季洁; 刘小涵; 折宁宁; 李丽; 张小兵

doi:10.13201/j.issn.1001-1781.2018.24.007

¹⁸F-FDG PET/CT和PET对结外鼻型NK/T细胞淋巴瘤诊断及分期价值的Meta分析

- 1 兰州市第一人民医院耳鼻咽喉科(兰州, 730050);
- 2 兰州大学第一医院
基金项目:
兰州市科技发展计划项目 (No:2018-3-71)

详细信息

通讯作者: 张小兵, E-mail:790736924@qq.com

中图分类号: R733.4

收稿日期: 2018-08-08

Value of ¹⁸F-FDG PET/CT and PET in diagnosing and staging extranodal nasal type natural killer/T-cell lymphoma:A Meta-analysis

- 1 Department of Otolaryngology, the First People's Hospital of Lanzhou, Lanzhou, 730050, China;
- 2 The First Hospital of Lanzhou University

More Information

Corresponding author: ZHANG Xiaobing, E-mail: 790736924@qq.com

Received Date: 08 August 2018

摘要

摘要: 目的: 采用Meta分析的方法评估¹⁸F-FDG PET/CT和PET在结外鼻型NK/T细胞淋巴瘤(ENKTL)中诊断及分期的价值。方法: 系统检索PubMed、Embase、Cochrane、Web of Science、CNKI、Wanfang、CBM和重庆维普数据库中有关¹⁸F-FDG PET/CT和PET诊断ENKTL的研究,检索时间截止至2018年6月。由两位研究人员采用双盲法按照纳入、排除标准进行文献筛选和资料提取,采用QUADAS-2评价标准评价纳入研究的质量后,使用Revmann 5.3和Stata 12.0软件进行Meta汇总分析,计算合并的敏感度(Sen)、特异度(Spe)、诊断比值比(DOR)及曲线下面积(AUC),以评价¹⁸F-FDG PET/CT和PET在ENKTL中诊断及分期的价值。结果: 共纳入10篇¹⁸F-FDG PET/CT及4篇PET诊断ENKTL的原始研究,分别包括457例患者的5 092个病灶和169例患者的384个病灶。Meta分析显示,¹⁸F-FDG PET/CT诊断ENKTL的Sen_合并=0.97(95%CI 0.93-0.99)、Spe_合并=0.97(95%CI 0.88-0.99)、DOR_合并=1 131.07(95%CI 167.77-7 625.28)、AUC=0.99(95%CI 0.98-1.00);PET诊断ENKTL的Sen_合并、Spe_合并、DOR_合并、AUC分别为0.81(95%CI 0.70-0.89)、0.90(95%CI 0.66-0.98)、39.63(95%CI 6.41-244.85)、0.86(95%CI 0.82-0.89)。通过Z检验分析结果可知,¹⁸F-FDG PET/CT诊断ENKTL的诊断效能(AUC=0.99,95%CI 0.98-1.00)明显高于PET(0.86,95%CI 0.82-0.89),且差异有统计学意义(Z=2.95,P=0.003)。结论: 相对于PET成像,¹⁸F-FDG PET/CT对ENKTL诊断及分期具有极高的价值,可被视为一种ENKTL无创诊断及分期的影像学方法。
- 18F-FDGPET/CT /
- PET /
- 结外鼻型 /
- NK/T细胞淋巴瘤 /
- Meta分析
Abstract: Objective: The aim of this study is to comprehensively evaluate the values of ¹⁸F-FDG PET/CT and PET in diagnosing extranodal nasal type natural killer/T cell lymphoma (ENKTL). Method: Studies about ENKTL diagnosed by ¹⁸F-FDG PET/CT and PET until June 2018 were searched in the databases such as PubMed, Embase, Cochrane, Web of Science, CNKI, CBM, VIP and Wanfang. Two reviewers independently screened literature and extracted data strictly according to included and excluded criterion, and assessed bias risk by 11 items using QUADAS-2 gulidline. Meta-analysis was performed by Revmann 5.3 and Stata 12.0 software. The pooled weighted Sentivity (Sen), Specificity (Spe), Diagnostic odds ratio (DOR) were calculated,summary receiver operator curve (SROC) and area under SROC curve (AUC) were also drawn. Result: Ten studies with 457 patients and 5 092 foci on ¹⁸F-FDG PET/CT and 4 studies with 169 patients and 384 foci on PET were finally included in our Meta-analysis.Our research showed that pooled Sen, Spe, DOR and AUC of ¹⁸F-FDG PET/CT diagnosing ENKTL were 0.97 (95%CI 0.93-0.99), 0.97(95%CI 0.88-0.99), 1 131.07(95%CI 167.77-7 625.28), 0.99(95%CI 0.98-1.00), and they were 0.81 (95%CI 0.70-0.89), 0.90(95%CI 0.66-0.98), 39.63(95%CI 6.41-244.85), 0.86(95%CI 0.82-0.89), respectively.Z test result reveled that ¹⁸F-FDG PET/CT had better diagnostic value in detecting ENKTL compared to PET:AUC=0.99(95%CI 0.98-1.00) vs AUC=0.86(95%CI 0.82-0.89), Z=2.95, P=0.003.Conclusion: In comparasion with PET, ¹⁸F-FDG PET/CT had excellent diagnostic value in detecting and staging ENKTL and may served as a non-invasive imaging in diagnosing and staging ENKTL.
- 18F-FDG PET/CT /
- PET /
- extranodal nasal /
- NK/T-cell lymphoma /
- Meta-analysis

HTML全文

参考文献(29)

[1]	KIM S J, YOON D H, JACCARD A, et al.A prognostic index for natural killer cell lymphoma after non-anthracycline-based treatment:a multicentre, retrospective analysis[J].Lancet Oncol, 2016, 17:389-400.
[2]	LI Y X, WANG H, JIN J, et al.Radiotherapy alone with curative intent in patients with stage I extranodal nasal-type NK/T-cell lymphoma[J].Int J Radiat Oncol Biol Phys, 2012, 82:1809-1815.
[3]	OHSHIMA K, NIINO D, MIYOSHI H.Peripheral T/NK cell lymphoma:current understanding and future perspectives[J].Rinsho Ketsueki, 2014, 55:418-427.
[4]	RATH S, CONNORS J M, DOLMAN P J, et al.Comparison of American Joint Committee on Cancer TNM-based staging system (7th edition) and Ann Arbor classification for predicting outcome in ocular adnexal lymphoma[J].Orbit, 2014, 33:23-28.
[5]	PAK K, KIM B S, KIM K, et al.Prognostic significance of standardized uptake value on F18-FDG PET/CT in patients with extranodal nasal type NK/T cell lymphoma:A multicenter, retrospective analysis[J].Am J Otolaryngol Head Neck Med Surg, 2018, 39:1-5.
[6]	TSE E, KWONG Y L.The diagnosis and management of NK/T-cell lymphomas[J].J Hematol Oncol, 2017, 10:85.
[7]	FEENEY J, HORWITZ S, GONEN M, et al.Characterization of T-cell lymphomas by FDG PET/CT[J].Am J Roentgenol, 2010, 195:333-340.
[8]	FUJIWARA H, MAEDA Y, NAWA Y, et al.The utility of positron emission tomography/computed tomography in the staging of extranodal natural killer/T-cell lymphoma[J].Eur J Haematol, 2011, 87:123-129.
[9]	KAKO S, LZUSTU K, OTA Y, et al.FDG-PET in T-cell and NK-cell neoplasms[J].Ann Oncol, 2007, 18:1685-1690.
[10]	KARANTANIS D, SUBRAMANIAM R M, PELLERP J, et al.The value of[(18) F]fluorodeoxyglucose positron emission tomography/computed tomography in extranodal natural killer/T-cell lymphoma[J].Clin Lymphoma Myeloma, 2008, 8:94-99.
[11]	KHONG P L, PANG C B, LIANG R, et al.Fluorine-18fluorodeoxyglucose positron emission tomography in mature T-cell and natural killer cell malignancies[J].Ann Hematol, 2008, 87:613-621.
[12]	MOON S H, CHO S K, KIM W S, et al.The role of 18F-FDG PET/CT for initial staging of nasal type natural killer/T-cell lymphoma:a comparison with conventional staging methods[J].J Nucl Med, 2013, 54:1039-1044.
[13]	WU H B, WANG Q S, WANG M F, et al.Utility of 18F-FDG PET/CT for staging NK/T-cell lymphomas[J].Nucl Med Commun, 2010, 31:195-200.
[14]	ZHOU M, ZHOU S, HAN H, et al.Role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with nasal-type natural killer T-cell lymphoma[J].Int J Clin Exp Med, 2018, 11:2148-2160.
[15]	ZHOU Z Y, CHEN C Y, LI X, et al.Evaluation of bone marrow involvement in extranodal NK/T cell lymphoma by FDG-PET/CT[J].Ann Hematol, 2015, 94:963-967.
[16]	党娜, 徐文贵, 宋秀宇, 等.18F-FDG PET-CT显像在原发结外淋巴瘤诊断中的应用价值[J].中华血液学杂志, 2014, 35 (1):35-39.
[17]	杜晓庆, 郁春景, 万卫星.18 F-FDG PET/CT在结外鼻型自然杀伤/T细胞淋巴瘤中的应用价值[J].中华核医学与分子影像杂志, 2016, 36 (6):490-494.
[18]	刘小婷.18 F-FDG PET/CT显像在鼻型结外自然杀伤/T细胞淋巴瘤诊断及分期中的应用[D].郑州:郑州大学, 2017.
[19]	甄玉莎, 徐文贵, 宋秀宇, 等.18 F-FDG PET-CT在NK/T细胞淋巴瘤诊断与鉴别诊断中的价值[J].中国实验诊断学, 2016, 20 (4):547-550.
[20]	吴琼, 马辰莺, 周菊英.原发鼻腔自然杀伤细胞/T细胞淋巴瘤放化疗预后分析[J].中华肿瘤防治杂志, 2015, 22 (15):1215-1220.
[21]	岳建兰, 尹亮, 黄世明, 等.鼻型结外NK/T细胞淋巴瘤的¹⁸F-FDG PET/CT表现及分期[J].中国医学影像学杂志, 2017, 25 (7):487-490.
[22]	DENG X W, WU J X, WU T, et al.Radiotherapy is essential after complete response to asparaginase-containing chemotherapy in early-stage extranodal nasaltype NK/T-cell lymphoma:A multicenter study from the China Lymphoma Collaborative Group (CLCG)[J].Radiother Oncol, 2018,[Epub ahead of print]
[23]	GELLER S, MYSKOWSKI P L, PULITZER M.NK/T-cell lymphoma, nasal type, gammadelta T-cell lymphoma, and CD8-positive epidermotropic T-cell lymphoma-clinical and histopathologic features, differential diagnosis, and treatment[J].Semin Cutan Med Surg, 2018, 37:30-38.
[24]	YAMAGUCHI M, SUZUKI R, OGUCHI M.Advances in the treatment of extranodal NK/T-cell lymphoma, nasal type[J].Blood, 2018, 131:2528-2540.
[25]	CASULO C, SCHODER H, FEENEY J, et al.18 F-fluorodeoxyglucose positron emission tomography in the staging and prognosis of T cell lymphoma[J].Leuk Lymphoma, 2013, 54:2163-2167.
[26]	李彤.鼻腔非霍奇金淋巴瘤的CT诊断[J].中华肿瘤防治杂志, 2016, 23 (S1):218-219.
[27]	刘海峰, 许永生, 陈小莉, 等.3D-TOF-MRA诊断颅内动脉瘤价值的Meta分析[J].临床放射学杂志, 2017, 36 (10):1396-1400.
[28]	折宁宁, 张小兵.磁共振成像在中耳胆脂瘤诊断价值的Meta分析[J].临床耳鼻咽喉头颈外科杂志, 2017, 31 (23):1833-1838.
[29]	李晓莹, 孙常领, 杜晓东.18 F-FDG PET/CT诊断cNO头颈部肿瘤患者颈淋巴结转移的Meta分析[J].临床耳鼻咽喉头颈外科杂志, 2018, 32 (9):700-704.