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中华介入放射学电子杂志 ›› 2021, Vol. 09 ›› Issue (02) : 177 -182. doi: 10.3877/cma.j.issn.2095-5782.2021.02.011

所属专题: 文献

基础研究

不同影像诊断方法对卵巢癌腹膜转移诊断价值的系统评价
黄世明1, 吴思雨2, 孙永锋3, 尹亮1, 岳建兰1, 林志春1,()   
  1. 1. 300162 天津,武警特色医学中心核医学科
    2. 300162 天津,武警特色医学中心妇产科
    3. 100027 北京,武警北京总队医院军事医学与特种学科
  • 收稿日期:2020-12-30 出版日期:2021-05-25
  • 通信作者: 林志春

Meta-analysis of the diagnostic value of different imaging methods for peritoneal metastasis of ovarian cancer

Shiming Huang1, Siyu Wu2, Yongfeng Sun3, Liang Yin1, Jianlan Yue1, Zhichun Lin1,()   

  1. 1. Department of Nuclear Medicine, Characteristic Medical Center of PAP, Tianjin 30016
    2. Department of Obstetrics and Gynecology, Characteristic Medical Center of PAP, Tianjin 300162
    3. Department of Military Medicine and Special Disciplines, Beijing 100027, China
  • Received:2020-12-30 Published:2021-05-25
  • Corresponding author: Zhichun Lin
引用本文:

黄世明, 吴思雨, 孙永锋, 尹亮, 岳建兰, 林志春. 不同影像诊断方法对卵巢癌腹膜转移诊断价值的系统评价[J/OL]. 中华介入放射学电子杂志, 2021, 09(02): 177-182.

Shiming Huang, Siyu Wu, Yongfeng Sun, Liang Yin, Jianlan Yue, Zhichun Lin. Meta-analysis of the diagnostic value of different imaging methods for peritoneal metastasis of ovarian cancer[J/OL]. Chinese Journal of Interventional Radiology(Electronic Edition), 2021, 09(02): 177-182.

目的

系统评价CT、MRI、PET/CT显像在卵巢癌腹膜转移的诊断价值。

方法

通过中文数据库及英文数据库,分别检索CT、MRI、PET/CT显像对原发性卵巢癌伴腹膜转移的诊断性临床试验,分别基于患者或病灶提取真阳性、假阳性、真阴性、假阴性等原始数据,通过软件Meta-Discl 1.4进行数据分析,分别合并计算CT、MRI、PET/CT显像诊断卵巢癌腹膜转移的敏感性(SEN)、特异性(SPE)、诊断比值比(DOR)。

结果

最终纳入16篇文献,系统评价结果显示,基于患者的分析结果中,CT显像对卵巢癌腹膜转移的SEN、SPE、DOR值分别为76%(95%CI:70%~82%)、82%(95%CI:77%~86%)、21.72(95%CI:4.74~99. 40),MRI显像分别为93%(95%CI:83%~98%)、81%(95%CI:73%~87%)、73.95(95%CI:20.56~265.98),PET/CT显像分别为73%(95%CI:63%~82%)、92%(95%CI:84%~97%)、30.29(95%CI:3.95~232.55)。基于病灶的分析结果中,CT显像对卵巢癌腹膜转移的SEN、SPE、DOR值分别为72%(95%CI:71%~74%)、86%(95%CI:85%~87%)、16.66(95%CI:4.23~65.58),MRI显像分别为87%(95%CI:85%~90%)、91%(95%CI:88%~92%)、68.28(95%CI:40.40~115.40),PET/CT显像分别为63%(95%CI:60%~66%)、87%(95%CI:84%~90%)、14.38(95%CI:5.81~35.59)。

结论

MRI是敏感性最高且特异性较强的检查方法,也是评估卵巢癌腹膜转移的最佳显像方法。

Objective

To systematically evaluate the diagnostic value of CT, MRI, PET/CT imaging in peritoneal metastasis of ovarian cancer.

Methods

The Chinese and English databases were used to retrieve the diagnostic clinical trials of primary ovarian cancer with peritoneal metastasis on CT, MRI, PET/CT imaging. True positive, false positive, true negative, false negative and other raw data were extracted based on patients or lesions and were analyzed using the software Meta-Discl 1.4.The sensitivity (SEN), specificity (SPE) and diagnostic odds ratio (Diagnostic odds ratio, DOR) of CT, MRI and PET/CT imaging in the diagnosis of peritoneal metastasis of ovarian cancer were calculated.

Results

Sixteen articles were finally included. The results of the systematic review showed that in the analysis results based on patients,the SEN, SPE, and DOR values of CT imaging for peritoneal metastasis of ovarian cancer were 76% (95%CI: 70%~82%), 82% (95%CI: 77%~86%), 21.72 (95%CI: 4.74~99. 40), those of MRI imaging were 93% (95%CI: 83%~98%), 81% (95%CI: 73%~87%), 73.95 (95%CI: 20.56~265.98), and those of PET/CT imaging were 73% (95%CI: 63%~82%), 92% (95%CI: 84%~97%), 30.29 (95%CI: 3.95~232.55). In the analysis results based on the lesions, the SEN, SPE and DOR values of CT imaging for peritoneal metastasis of ovarian cancer were 72% (95%CI: 71%~74%), 86% (95%CI: 85%~87%) and 16.66 (95%CI: 4.23~65.58), those of MRI imaging were 87% (95%CI: 85%~90%), 91% (95%CI: 88%~92%), 68.28 (95%CI: 40.40~115.40), and those of PET/CT imaging were 63% (95%CI: 60%~66%), 87% (95%CI: 84%~90%), 14.38 (95%CI: 5.81~35.59).

Conclusions

MRI is the most sensitive and specific examination method and it is the best imaging method for evaluating peritoneal metastasis of ovarian cancer.

表1 纳入文献基本特征
作者 发表时间 国家 平均年龄/岁 设计方法 金标准 病例入组时间 QUADAS
否/不清楚
基于患者的研究                
  Lopez-Lopez V[4] 2016 西班牙 54(27~78) 回顾性 病理 2008.01—2014.05 11 3
  Rubini G[5] 2014 意大利 59.83(30~83) 回顾性 病理 NR 10 3
  Kim HW[6] 2013 韩国 54(29~80) 回顾性 病理 2007.01—2010.06 12 2
  Dirisamer A[7] 2009 奥地利 61(43~81) 回顾性 病理 2003.07—2005.08 13 1
  Coakley FV[8] 2002 美国 55(28~81) 回顾性 病理 1996.06—2000.08 12 2
  Tempany CM[9] 2000 美国 57(19~79) 前瞻性 病理 1993.05—1996.04 11 2
  Fujii S[10] 2008 日本 62(30~83) 回顾性 病理 2005.01—2006.06 11 3
基于病灶的研究                
  Ahmed SA[11] 2019 埃及 51(22~72) 回顾性 病理 2014.01—2018.03 13 1
  Schmidt S[12] 2015 瑞士 65(31~89) 前瞻性 病理 NR 11 3
  Michielsen K[13] 2014 比利时 69.1(20~83) 前瞻性 病理 2010.10—2012.02 12 2
  Hynninen J[14] 2013 芬兰 65(45~79) 前瞻性 病理 2009.10—2012.03 12 2
  Metser U[15] 2011 加拿大 58.2(24~87) 回顾性 病理 2005.01—2008.03 13 1
  Choi HJ[16] 2011 韩国 53.1(30~72) 回顾性 病理 2006.07—2008.01 12 2
  Funicelli L[17] 2010 意大利 NR 回顾性 病理 2001—2008 11 3
  Prado JG[18] 2019 西班牙 56±12.69 前瞻性 病理 2014.06—2017.01 12 2
  张圆[19] 2019 中国 54.6(35~67) 回顾性 病理 2016.10—2017.11 12 2
表2 纳入研究统计信息
作者 诊断方法 病例数 病灶数 TP FP FN TN SEN(%) SPE(%) ACC(%) PPV(%) NPV(%)
基于患者的研究                        
  Lopez-Lopez V[4] CT 44 767 6 1 11 26 35.00 96.30 73.28 85.03 71.13
    PET/CT 46 767 4 2 13 27 24.00 93.00 67.73 66.00 68.00
  Rubini G[5] CT 79   23 14 20 22 53.57 60.87 56.86 62.50 51.85
    PET/CT 79   34 3 9 33 78.57 91.30 84.32 91.67 77.78
  Kim HW[6] CT 46   23 7 3 13 88.50 65.00 78.26 76.70 81.30
    PET/CT 46   25 2 1 18 96.20 90.00 93.48 92.60 94.70
  Dirisamer A[7] CT 62   26 1 5 30 83.87 96.77 90.32 96.30 85.71
  Coakley FV[8] CT 64   35 2 6 21 85.37 91.30 87.50 94.59 77.78
  Tempany CM[9] CT 212   46 30 4 132 92.00 81.48 83.96 60.53 97.06
    常规MRI 175   39 27 2 107 95.12 79.85 83.43 59.09 98.17
  Fujii S[10] MRI (DWI) 26   13 1 2 10 86.67 90.91 88.46 92.86 83.33
基于病灶的研究                        
  Ahmed SA[11] CT 85 925 725 20 50 130 93.55 86.67 92.43 97.90 72.20
  Schmidt S[12] CT 17 135 77 4 3 50 96.00 92.00 94.60 95.00 94.00
    MRI (DWI) 17 135 84 8 2 41 98.00 84.00 92.59 91.00 96.00
    PET/CT 17 135 80 2 4 49 95.00 96.00 95.65 98.00 92.00
  Michielsen K[13] CT 32 475 136 47 72 220 65.38 82.40 74.95 74.32 75.34
    MRI (DWI) 32 475 189 24 19 243 90.87 91.01 90.95 88.73 92.75
    PET/CT 32 475 108 39 100 228 51.92 85.39 70.74 73.47 69.51
  Hynninen J[14] CT 41 856 193 20 288 355 40.12 94.67 64.02 90.61 55.21
    PET/CT 41 713 237 25 226 225 51.19 90.00 64.80 90.46 49.89
  Metser U[15] CT 76 1 845 337 79 78 1 351 81.20 94.48 91.49 81.01 94.54
  Choi HJ[16] CT 57 741 114 135 137 355 45.42 72.45 63.29 45.78 72.15
  Funicelli L[17] CT 89 310 155 97 35 23 81.58 19.17 57.42 61.51 39.66
  Prado JG[18] MRI (DWI) 50 650 13 1 2 10 86.67 90.91 88.46 92.86 83.33
  张圆[19] MRI (DWI) 39 273 99 12 26 136 79.20 91.89 86.08 89.19 83.95
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