文章：

一项系统回顾与荟萃分析：基于29项研究评估CT、MRI、PET及超声在头颈癌包膜外侵犯诊断中的准确性预测

A Systematic Review and Meta-Analysis of 29 Studies Predicting Diagnostic Accuracy of CT, MRI, PET, and USG in Detecting Extracapsular Spread in Head and Neck Cancers

原文发布日期：10 April 2024

DOI: 10.3390/cancers16081457

类型: Article

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英文摘要：

Background: Extracapsular spread (ECS) is the extension of cancer cells beyond the lymph node capsule and is a significant prognostic factor in head and neck cancers. This meta-analysis compared the diagnostic accuracy of CT, MRI, PET, and USG in detecting ECS in head and neck cancers. Methodology: The authors conducted a systematic review and meta-analysis of studies that compared the diagnostic accuracy of CT, MRI, PET, and USG in detecting ECS in head and neck cancers. They included studies that were published between 1990 and December 2023 and that used histopathology as the reference standard for ECS. Results: The pooled sensitivity and specificity of CT scan were 0.63 (95% CI = 0.53–0.73) and 0.85 (95% CI = 0.74–0.91), respectively. The pooled sensitivity and specificity of MRI were 0.83 (95% CI = 0.71–0.90) and 0.85 (95% CI = 0.73–0.92), respectively. The pooled sensitivity and specificity of PET were 0.80 (95% CI = 0.74–0.85) and 0.93 (95% CI = 0.92–0.94), respectively. The pooled sensitivity and specificity of USG were 0.80 (95% CI = 0.68–0.88) and 0.84 (95% CI = 0.74–0.91), respectively. MRI had significantly higher sensitivity than CT scan (p-0.05). The specificity of CT and MRI was not significantly different (p-0.99). PET scan had the highest specificity among all imaging modalities. Conclusion: MRI is the most accurate imaging modality for detecting ECS in head and neck cancers. CT scan is a reasonable alternative, but PET scan may be considered when high specificity is required. USG may not add any further benefit in detecting ECS.

摘要翻译： 

背景：包膜外扩散（ECS）是指癌细胞突破淋巴结包膜向外浸润，是头颈部癌症的重要预后因素。本荟萃分析比较了CT、MRI、PET和超声在检测头颈部癌症ECS中的诊断准确性。 方法：作者对1990年至2023年12月期间发表的、以组织病理学为ECS金标准的研究进行了系统综述和荟萃分析，比较CT、MRI、PET和超声在检测头颈部癌症ECS中的诊断效能。 结果：CT检查的汇总敏感性和特异性分别为0.63（95% CI = 0.53–0.73）和0.85（95% CI = 0.74–0.91）；MRI分别为0.83（95% CI = 0.71–0.90）和0.85（95% CI = 0.73–0.92）；PET分别为0.80（95% CI = 0.74–0.85）和0.93（95% CI = 0.92–0.94）；超声分别为0.80（95% CI = 0.68–0.88）和0.84（95% CI = 0.74–0.91）。MRI的敏感性显著高于CT（p=0.05），而CT与MRI的特异性无显著差异（p=0.99）。PET在所有影像学检查中特异性最高。 结论：MRI是检测头颈部癌症ECS最准确的影像学方法。CT可作为合理替代方案，但在需要高特异性时可考虑PET检查。超声对ECS检测可能无额外增益。

原文链接：

A Systematic Review and Meta-Analysis of 29 Studies Predicting Diagnostic Accuracy of CT, MRI, PET, and USG in Detecting Extracapsular Spread in Head and Neck Cancers