Accuracy of diagnosing para-aortic and pelvic lymph node metastasis in cervical cancer with PET/CT:a meta analysis
ZHAI Ya-nan1, GUO Shun-lin1, ZHOU Huai-qi1, WANG Ping1, WANG Hai-jun2
1.Department of Radiology, the First Affiliated Hospital of Lanzhou University, Lanzhou 730000, China;2.Center of PET/CT, People’s Hospital of Gansu Province, Lanzhou 730000, China
Abstract：Objective: To review studies focused on diagnosing pelvic and para-aortic lymph node metastasis in cervical cancer with PET/CT, analyse sources of bias and variability and evaluate the diagnostic accuracy with meta analysis. Methods: Searched current literature in database without limiting time and language, evaluated the quality of included studies according to QUADAS(Quality assessment of diagnostic accuracy studies), MetaDisc version 1.40 software was used to pool sensitivity, specificity, positive likelihood ratio(+LR), negative likelihood ratio(-LR) and diagnostic OR, analysed source of heterogeneity with Q-test and drew SROC curves. Results: Nine studies met the inclusion criteria, eight literatures written in English and one in Chinese. 346 cases of cervical cancer(3979 lymph node metastasis) were included, we pooled data with random effects model on lymph nodes level: sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, accuracy and AUC value were 0.58[95% confidence interval(CI) 0.51~0.65], 0.98 (95%CI 0.98~0.99), 0.686(0.464~0.852), 0.936(0.833~0.995), 2.15(7.20~64.24), 0.43(0.32~0.58), 0.900(0.75~0.993), 0.7724, respectively; pooled analysis with random effects model based on patient level: sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, accuracy and AUC value were 0.54(95%CI 0.45~0.63), 0.86(95%CI 0.98~0.99), 0.725(0.471~0.923), 0.765(0.615~0.886), 4.58(1.86~11.31), 0.52(0.34~0.80), 0.756(0.620~0.0.897) and 0.8699, respectively. Conclusion: PET/CT has moderate diagnostic value for evaluating pelvic and aortic lymph node metastasis in cervical cancer, which can provide reliable guidance in clincal practice．
2011, Vol. 22 
