目的 孤立性肺结节(solitary pulmonary nodule, SPN)的定性诊断十分困难,PET/CT是目前评价良、恶性病变最具优势的影像学手段之一.文中用Meta分析方法综合评价18F-脱氧葡萄糖(18Fluorodexglucose,FDG)PET/CT显像诊断恶性孤立性肺结节的价值. 方法 以孤立性肺结节、FDG、PET/CT等为检索词,检索1994年1月至2009年7月的Medline数据库、西文生物医学期刊文献服务系统、外文生物医学期刊全文数据库、中国学术期刊网全文数据库等相关中英文文献.对符合标准的研究进行质量评估,用MetaDisc1.4软件进行异质性检验,综合敏感性、特异性和诊断优势比,绘制汇总受试者工作特征(summary receiver operating characteristic, SROC)曲线和计算曲线下面积(the area under the curve,AUC),并进行敏感性分析. 结果共检索相关文献29篇,其中11篇符合标准纳入分析,A级1篇,B级10篇,各研究之间存在异质性,按照随机效应模型合并敏感性、特异性、诊断优势比(diagnostic odds ratio, DOR)及其95%可信区间分别为91%(87% ～93%)、83%(78% ～87%)和51.04(23.33 ～111.66),AUC为0.9383,Q值为0.8753,纳入文献稳定性较好. 结论 18F-FDG PET/CT显像能灵敏、准确地诊断恶性孤立性肺结节,具有较高的临床应用价值.%Objective Solitary pulmonary nodules are very difficult to be diagnosed correctly. PET/CT is the most advanced imaging methods for the differentiation of benign from malignant disease. The authors present a Meta-analysis on the value of 18F-FDC PET/CT in che diagnosis of solitary pulmonary nodules. Methods We searched English and Chinese literature for relevant publications using the key words "solitary pulmonary nodule" , "FDG" , and "PET/CT' , evaluated the quality of the identified studies, and conducted a heterogenety test with the MetaDise 1.4 software. Then we measured the sensitivity, specificity and diagnostic odds ratio ( DOR) , drew a summary receiver operating charactenstic ( SROC) curve, calculated the area under the curve ( AUC) , and finally performed a sensitivity analysis. Results Eleven of the twenly-nine identified studies were eligible for this Meta-analysis. Because of the heterogeneity among the included articles, a proper effect model was selected to calculate the pooled sensitivity ( 91％ ,87％93％ ) , specificity ( 83％ ,78％- 87％ ) and DOR ( 51. 04 ,23. 33 - 111. 66) with 95％ confidence intervals. The area under the SROC curve was 0. 9383 and the Q index was 0. 875 3. Conclusion 18F-FDG PET/CT is considerably favorable for clinical application in the diagnosis of malignant solitary pulmonary nodules with high sensitivity and accuracy.
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