| 卢 艳,覃小青,秦文艳.前哨淋巴结示踪应用于宫颈癌的可行性和诊断盆腔淋巴结转移敏感性的Meta分析[J].中国肿瘤,2020,29(1):70-80. |
| 前哨淋巴结示踪应用于宫颈癌的可行性和诊断盆腔淋巴结转移敏感性的Meta分析 |
| Sentinel Lymph Node Mapping in Diagnosis of Pelvic Lymph Node Metastasis of Cervical Cancer：A Meta Analysis |
| 中文关键词 修订日期：2019-04-19 |
| DOI：10.11735/j.issn.1004-0242.2020.01.A010 |
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| 中文关键词: 宫颈癌 前哨淋巴结示踪 淋巴结转移 敏感性 Meta分析 |
| 英文关键词:cervical cancer sentinel lymph node mapping lymph node metastasis,sensitivity Meta analysis |
| 基金项目:广西重点研发计划（桂科AB17292092）；广西医疗卫生适宜技术研究与开发项目（S2017100） |
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| 中文摘要: |
| 摘 要：［目的］ 系统评价前哨淋巴结（sentinel lymph node，SLN）技术应用于早期宫颈癌的可行性及对淋巴结转移诊断的临床价值。［方法］ 计算机检索PubMed、 Embase、Cochrane Library以及万方等数据库，检索建库开始至2018年10月2日国内外关于SLN检测应用于早期宫颈癌的研究，通过QUADAS-2（Quality Assessment of Diagnostic Accuracy Studies-2）对文献进行质量评估，用Stata12.0软件对数据进行统计学分析，分析这些研究诊断淋巴结转移的敏感性。［结果］ 共纳入36个研究（3853例患者），总的敏感性为0.91 ( 95％CI：0.88～0.93)，I2=16.73%(95％CI：0～51.39%)，汇总受试者曲线的ROC=0.99（0.98～1.00）。合并后的总检出率为97.10% (95%CI：96.50%～97.80%)，异质性检验 I2=90.80%(P=0.000)，合并后的双侧SLN检出率为69.20%(95%CI：62.80%～75.50%)，异质性检验I2=95.70%(P=0.000)，异质性较高，需要进行亚组分析。［结论］ SLN示踪技术应用于宫颈癌具有可行性，对于诊断宫颈癌淋巴结转移敏感性高，病理超分期对淋巴结转移诊断的优势还需更大样本量的结果来验证，示踪剂的选择、肿瘤的大小是双侧检出率的主要影响因素。 |
| 英文摘要: |
| Abstract：［Purpose］ To systematically evaluate the feasibility of sentinel lymph node(SLN) detection in the diagnosis of lymph node metastasis of cervical cancer. ［Methods］ The databases PubMed，Embase，Cochrane Library，and Wanfang were searched to retrieve studies on the application of SLN detection in diagnosis of lymph node metastasis in cervical cancer from incept to October 2018. The quality of the literature was evaluated by QUADAS-2(Quality Assessment of Diagnostic Accuracy Studies-2)，and the data were analyzed using Stata12.0 software. ［Results］ A total of 36 studies involving 3853 patients were included. The total sensitivity was 0.91(95%CI：0.88～0.93)，I2=16.73%(95%CI：0～51.39%)，and the area under the ROC curve(AUC) was 0.99(0.98～1.00). The combined detection rate was 97.10%(95%CI：96.50%～97.80%)，heterogeneity I2=90.8%(P=0.000)，and the combined bilateral SLN detection rate was 69.20%(95%CI：62.80%～75.50%)，I2=95.70%(P=0.000)，with high heterogeneity，and subgroup analysis was required. ［Conclusion］ SLN technology is feasible for cervical cancer，it has high sensitivity for diagnosing lymph node metastasis. The advantages of pathologic ultrastaging for diagnosis of lymph node metastasis need to be verified by a larger sample size. The choice of tracer and the size of the tumor are the main influencing factors of the bilateral detection rate. |
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