Optimal Modality for Detecting Distant Metastasis in Primary Nasopharyngeal Carcinoma during Initial Staging: A Systemic Review and Meta-analysis of 1774 Patients
Purpose: To compare the diagnostic performance of two modalities commonly used for detecting distant metastasis in primary nasopharyngeal carcinoma (NPC): 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) and conventional work-ups (CWUs). Methods: All topic-related studies were comprehensively searched and included. We determined sensitivities and specificities across studies, calculated negative and positive likelihood ratios (LR-and LR+, respectively), and constructed summary receiver operating characteristic curves. Moreover, we compared the diagnostic performance of PET/CT and CWUs by analyzing studies that reported the results of these diagnostic methods on the same patients. Results: The pooled sensitivity and specificity were 85.7% and 98.1% for PET/CT (1474 patients), and 38.0% and 97.6% for CWUs (1329 patients). In the head-to-head comparison of PET/CT and CWUs (1029 patients), PET/CT showed a significantly higher sensitivity (83.7% vs. 40.1%, P < 0.001) and lower LR- (0.169 vs. 0.633, P < 0.001) than CWUs on a per-patient basis; no significant difference was observed in pooled specificity (97.7% vs. 97.8%, P = 0.892) or LR+ (36.416 vs. 16.845, P = 0.149). The superiority of PET/CT over CWUs was due mainly to the better diagnostic performance on bone metastasis. However, suboptimal sensitivity of PET/CT was reported in the aspect of detection of liver metastasis. Sensitivity analyses showed relatively poor sensitivity and LR-of PET/CT compared to the original analysis. Conclusions: PET/CT was superior to CWUs in detecting distant metastasis in primary NPC. However, the efficacy of PET/CT in detecting liver metastasis still requires further optimization.
基金:
National Science & Technology Pillar Program during the Twelfth Five-year Plan Period [2014BAI09B10]; Science and Technology Project of Guangzhou City, China [14570006]; Planned Science and Technology Project of Guangdong Province, China [2013B020400004]; Health & Medical Collaborative Innovation Project of Guangzhou City, China [201400000001]; National Natural Science Foundation of ChinaNational Natural Science Foundation of China [81230056]
语种:
外文
被引次数:
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中科院(CAS)分区:
出版当年[2017]版:
大类|3 区医学
小类|3 区肿瘤学
最新[2023]版:
大类|3 区医学
小类|4 区肿瘤学
第一作者:
第一作者机构:[1]Sun Yat Sen Univ, Canc Ctr, State Key Lab Oncol South China, Collaborat Innovat Ctr Canc Med,Dept Radiat Oncol, Guangzhou, Peoples R China;
通讯作者:
通讯机构:[1]Sun Yat Sen Univ, Canc Ctr, State Key Lab Oncol South China, Collaborat Innovat Ctr Canc Med,Dept Radiat Oncol, Guangzhou, Peoples R China;[4]Sun Yat Sen Univ, Canc Ctr, State Key Lab Oncol South China, Dept Radiat Oncol,Collaborat Innovat Ctr Canc Med, 651 Dongfeng Rd East, Guangzhou 510060, Guangdong, Peoples R China
推荐引用方式(GB/T 7714):
Xu Cheng,Zhang Yuan,Peng Liang,et al.Optimal Modality for Detecting Distant Metastasis in Primary Nasopharyngeal Carcinoma during Initial Staging: A Systemic Review and Meta-analysis of 1774 Patients[J].JOURNAL OF CANCER.2017,8(7):1238-1248.doi:10.7150/jca.18361.
APA:
Xu, Cheng,Zhang, Yuan,Peng, Liang,Liu, Xu,Li, Wen-Fei...&Ma, Jun.(2017).Optimal Modality for Detecting Distant Metastasis in Primary Nasopharyngeal Carcinoma during Initial Staging: A Systemic Review and Meta-analysis of 1774 Patients.JOURNAL OF CANCER,8,(7)
MLA:
Xu, Cheng,et al."Optimal Modality for Detecting Distant Metastasis in Primary Nasopharyngeal Carcinoma during Initial Staging: A Systemic Review and Meta-analysis of 1774 Patients".JOURNAL OF CANCER 8..7(2017):1238-1248