【摘要】 目的对18F-FDG PET双时相扫描方法鉴别肺部良恶性病变的准确性进行系统评价,明确双时相扫描的必要性和临床价值。方法计算机检索PubMed、EMbase、Th e Cochrane Library、WanFang Data、CNKI和CBM数据库,检索时限从1990年1月至2011年11月,纳入18F-FDG PET双时相扫描与金标准(手术式穿刺活检结果)比较鉴别肺部良恶性病变的诊断性试验。由2位研究者按纳入与排除标准进行文献筛选、资料提取与纳入研究的方法学质量评价后,计算其敏感度与特异度合并效应量以及受试者工作特征曲线下面积(AUC),并进行敏感性分析和亚组分析。结果共纳入19篇文献,包括1 225个病灶。Meta分析结果显示:双时相18F-FDG PET鉴别肺部良恶性病变的敏感度为0.82[95%CI(0.79,0.85)],特异度为0.74[95%CI(0.71,0.78)],AUC为0.837 5。敏感性分析结果显示:①剔除结核病变占良性病变比例>50%的研究,合并敏感度为0.81[95%CI(0.77,0.84)],特异度为0.76[95%CI(0.72,0.80)],AUC为0.850 3;②剔除样本量<50例的研究,合并敏感度为0.78[95%CI(0.74,0.82)],特异度为0.78[95%CI(0.74,0.82)],AUC为0.814 1;③剔除iSUV(首次标准摄取值)>2.5的研究,合并敏感度为0.67[95%CI(0.55,0.78)],特异度为0.66[95%CI(0.54,0.77)],AUC为0.779 8。结论 18F-FDG PET双时相扫描具有中等诊断价值,跟单时相扫描相比不具有优势,双时相扫描不必作为常规检查应用于临床。更多还原

【Abstract】 Objective To systematically review the diagnostic accuracy of 18F-FDG PET dual time point scan in identifying benign and malignant lung lesions,in order to necessity and clinical value of dual time point scan. Methods We electronically searched PubMed,EMbase,The Cochrane Library,WanFang Data,CNKI and CBM for diagnostic tests on 18F-FDG PET dual time point scan vs. surgery or needle biopsy(gold standard) from January 1990 to November 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria,extracted data,and assessed the methodological quality of included studies. Then statistical analysis was performed to calculate pooled effect sizes of sensitivity(SEN) and specifi city(SPE),and area under the curve(AUC) of summary receiver operating characteristics(SROC),followed by sensitive analysis and subgroup analysis. Results A total of 19 domestic and foreign studies were totally included,involving 1 225 lesions. The results of meta-analysis showed SEN 0.82(95%CI 0.79 to 0.85) and SPE 0.74(95%CI 0.71 to 0.78) regarding 18F-FDG PET dual time point scan in identifying benign and malignant lung lesions. The results of sensitive analysis showed that:a) aft er eliminating studies in which tuberculosis in the benign lesions accounted for more than 50%,it showed pooled SEN 0.81(95%CI 0.77 to 0.84),pooled SPE 0.76(95%CI 0.72 to 0.80),and AUC 0.850 3; b) aft er eliminating studies in which sample size was less than 50 cases,it showed pooled SEN 0.78(95%CI 0.74 to 0.82),pooled SPE 0.78(95%CI 0.74 to 0.82),and AUC 0.814 1; and c) aft er eliminating studies in which iSUV was more than 2.5,it showed pooled SEN 0.67(95%CI 0.55 to 0.78),pooled SPE 0.66(95%CI 0.54 to 0.77),and AUC 0.779 8. Conclusion 18F-FDG PET dual time point scan has intermediate value in identifying benign and malignant lung lesions,which is almost as good as single time point scan,so it’s unnecessary to apply it as a clinical routine test.更多还原