~(18)F-脱氧葡萄糖-正电子发射/计算机体层扫描对肺部良恶性病变鉴别诊断价值的荟萃分析

摘要

Objective Using Meta analysis to evaluate the value of ~(18)F-FDG PET/CT(~(18)fluorinefluorodeoxyglucose Positron emission tomography/computed tomography)in differentiating between benign and malignant pulmonary lesions.Methods Relevant documentations from PubMed and other 5 databases from 1980 to 2008 were searched,and the eligible literatures according to the inclusive criteria were selected.The statistical information and quality of science were assessed and classified.The data were analyzed using Meta-Discl.4 software.The diagnostic value of PET/CT in distinguishing benign from malignant pulmonary lesions was evaluated by the pooled sensitivity,specificity,the likelihood ratio(LR) and summary receiver operating characteristic curve(SROC curve)statistical indicators.Results Seven literatures were collected including 5 in English and 2 in Chinese,and 795 cases were included in the study.Heterogeneity test showed that the homogeneity of the study was good.By using deterministic models to analyze the data,the value of the weighted sensitivity was,95%(93%～97%),the specificity Was 77% (71%～82%),the positive likelihood ratio Was 4.12,negative Iikelihood ratio was 0.08,and the SROC area under the curve(area under curve,AUC)was 94%.Conclusion PET/CT is of high diagnostic value in differentiation between benign and malignant lung lesions,but large sized,multicenter,prospective studies are needed to assess its clinical value more accurately.%目的 应用荟萃分析方法综合评价~(18)F-脱氧葡萄糖-正电子发射/计算机体层扫描(~(18)F-FDG PET/CT)对肺部良恶性病变的鉴别诊断价值.方法 应用"PET/CT&lung cancer"等检索词在PubMed等数据库检索1980-2008年发表的相关文献,根据纳入标准筛选符合条件的文献,并对文献进行信息统计、科学性评估及质量分级;采用Meta-Disc1.4和RewMan 4.2软件进行数据分析;通过汇总敏感度和特异度、汇总似然比及汇总受试者工作特征曲线(SROC曲线)等统计指标综合评价~(18)F-FDG PET/CT对肺部良恶性病变的鉴别诊断价值.结果 共纳入7篇文献,其中英文5篇,中文2篇,样本量为795例.异质性检验显示纳入研究齐性好,通过确定模型的汇总计算得出汇总敏感度为95%(93%～97%),汇总特异度为77%(71%～82%).汇总阳性似然比为4.12,汇总阴性似然比为0.08,SROC曲线下面积为94%.结论 ~(18)F-FDG PET/CT对肺部良恶性病变的鉴别诊断具有较大价值,但仍需要开展更大样本、多中心、高质量的前瞻性研究,以更准确地评价其临床价值.