Effect of FDG-PET/CT in Diagnosis, Staging and Prognosis of Pancreatic Cancer: A Meta-analysis
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摘要:目的
系统评价FDG-PET/CT在胰腺癌诊断、分期及预后预测中的作用。
方法对数据库PubMed、Ovid、Cochrane Library、CNKI和VIP进行计算机检索，筛选相关文献后提取数据、根据QUADAS进行质量评估并采用Meta-Disc和Stata进行数据分析。
结果胰腺癌诊断、分期和预后相关文献共42篇纳入研究。Meta分析结果显示，FDG-PET/CT对胰腺癌的诊断、淋巴结转移和远期转移诊断敏感度合并和特异性合并分别为0.93（95%CI: 0.92~0.94）、0.65（95%CI: 0.56~0.74）和0.82（95%CI: 0.71~0.90)，其对应的特异性合并分别为0.73（95%CI: 0.70~0.76）、0.86（95%CI: 0.79~0.91）和0.95（95%CI: 0.91~0.98）。预后分析结果显示，总生存期（HR合并=1.96, 95%CI: 1.52~2.52）和无进展生存期（HR合并=2.26, 95%CI: 1.33~3.83）在高低SUVmax组间差异有统计学意义。
结论FDG-PET/CT可作为胰腺癌诊断和总生存期预测分析的重要影像学工具，但其在胰腺癌分期中的作用仍待进一步研究。
Abstract:ObjectiveTo assess the potential role of deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the diagnosis, staging and prognosis of pancreatic cancer using Meta-analysis.
MethodsComputer-based retrieval was conducted on PubMed, Ovid, Cochrane Library, CNKI and VIP to search reports about diagnosis, staging and prognosis of pancreatic cancer, collected data and evaluated the quality based QUASAD. All calculations were performed by Meta-Disc software and Stata software.
ResultsStudies related to diagnosis, staging and prognosis: 42 articles in total were finally included after deducting repeats. The pooled sensitively of FDG-PET/CT in diagnosis pancreatic cancer, evaluating lymph node metastasis and distant metastasis were 0.93 (95%CI: 0.92-0.94), 0.65 (95%CI: 0.56-0.74) and 0.82 (95%CI: 0.71-0.90), respectively; and the corresponding specificity was 0.73 (95%CI: 0.70-0.76), 0.86 (95%CI: 0.79-0.91) and 0.95 (95%CI: 0.91-0.98), respectively. In prognosis analysis, significant difference of overall survival (HRpooled=1.96, 95%CI: 1.52-2.52) and progress free survival (HRpooled=2.26, 95%CI: 1.33-3.83) were both observed between high and low standardized uptake value groups.
ConclusionFDG-PET/CT can be used as a valuable tool for diagnosis and prediction of overall survival for pancreatic cancer; however, the effect in the staging of pancreatic cancer was still indeterminate and to be further researched.
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Key words:
- FDG-PET/CT /
- Pancreatic Cancer /
- Diagnosis /
- Staging /
- Prognosis /
- Meta-analysis
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图 1 筛选FDG-PET/CT对胰腺癌诊断、分期和预后的文献流程
Figure 1 Flow chart for FDG-PET/CT in diagnosis, staging and prognosis of pancreatic cancer filtering
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图 2 FDG-PET/CT对胰腺癌预后分析的Meta分析森林图
Figure 2 Forest plot of FDG-PET in prognosis of pancreatic cancer
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图 4 FDG-PET/CT对胰腺癌诊断Meta分析的漏斗图
Figure 4 Funnel plot based on the data of FDG-PET/CT for the diagnosis of pancreatic cancer
表 1 36篇被纳入的FDG-PET/CT对胰腺癌诊断性研究的文献特征
Table 1 Characteristics of 36 included studies for FDG-PET/CT in diagnositic pancreatic cancer
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表 2 7篇被纳入的FDG-PET/CT对胰腺癌淋巴结和远期转移研究的文献特征
Table 2 Characteristics of 5 included studies for FDG-PET/CT in lymph node metastasis and distant metastasis of pancreatic cancer
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表 3 5篇被纳入FDG-PET/CT对胰腺癌预后预测研究的文献特征
Table 3 Characteristic of 5 included studies for FDG-PET/CT in prognosis of pancreatic cancer
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表 4 FDG-PET/CT对胰腺癌诊断及分期的Meta分析
Table 4 Meta-analysis of FDG-PET/CT in diagnosis and staging of pancreatic cancer
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