中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2014年
3期
258-263
,共6页
黄忠明%初丽丽%赵日升%王辉
黃忠明%初麗麗%趙日升%王輝
황충명%초려려%조일승%왕휘
直肠肿瘤%磁共振成像%术前放化疗%诊断价值%Meta分析
直腸腫瘤%磁共振成像%術前放化療%診斷價值%Meta分析
직장종류%자공진성상%술전방화료%진단개치%Meta분석
Rectal neoplasms%Magnetic resonance imaging%Preoperatave chemoradiotherapy%Diagnostic value%Meta-analysis
目的 评价磁共振成像(MRI)对直肠癌术前放化疗后再分期的准确性.方法 利用PubMed、EMBASE、Ovid和Wok数据库,全面检索MRI对直肠癌术前放化疗后再分期相关的英文文献,检索日期1985年1月至2012年3月.对MRI用以直肠癌术前放化疗后再分期的敏感性和特异性进行Meta分析.结果 最终纳入15篇,共749例患者.MRI对直肠癌术前放化疗后T3～T4分期诊断的敏感性为82.1％(95％CI:67.9％～90.9％),特异性为53.5％(95％CI:39.3％～67.3％),诊断比数比(DOR)为5.34 (95％ CI:2.73～10.45);对阳性淋巴结诊断的敏感性、特异性及DOR分别为61.8％ (95％CI:50.7％～71.8％)、72.0％ (95％CI:61.3％～80.7％)和4.33 (95％CI:2.84～6.59);对环周切缘阳性诊断的敏感性、特异性及DOR分别为85.4％ (95％CI:60.5％～95.7％)、80.0％(95％CI:57.4％～92.2％)和27.62(95％CI:13.03～58.55).结论 MRI对于直肠癌术前放化疗后T3～T4和阳性淋巴结诊断准确性一般,而对环周切缘诊断准确性高.推荐术前常规利用MRI对直肠癌患者进行放化疗后再分期,以避免过度治疗.
目的 評價磁共振成像(MRI)對直腸癌術前放化療後再分期的準確性.方法 利用PubMed、EMBASE、Ovid和Wok數據庫,全麵檢索MRI對直腸癌術前放化療後再分期相關的英文文獻,檢索日期1985年1月至2012年3月.對MRI用以直腸癌術前放化療後再分期的敏感性和特異性進行Meta分析.結果 最終納入15篇,共749例患者.MRI對直腸癌術前放化療後T3～T4分期診斷的敏感性為82.1％(95％CI:67.9％～90.9％),特異性為53.5％(95％CI:39.3％～67.3％),診斷比數比(DOR)為5.34 (95％ CI:2.73～10.45);對暘性淋巴結診斷的敏感性、特異性及DOR分彆為61.8％ (95％CI:50.7％～71.8％)、72.0％ (95％CI:61.3％～80.7％)和4.33 (95％CI:2.84～6.59);對環週切緣暘性診斷的敏感性、特異性及DOR分彆為85.4％ (95％CI:60.5％～95.7％)、80.0％(95％CI:57.4％～92.2％)和27.62(95％CI:13.03～58.55).結論 MRI對于直腸癌術前放化療後T3～T4和暘性淋巴結診斷準確性一般,而對環週切緣診斷準確性高.推薦術前常規利用MRI對直腸癌患者進行放化療後再分期,以避免過度治療.
목적 평개자공진성상(MRI)대직장암술전방화료후재분기적준학성.방법 이용PubMed、EMBASE、Ovid화Wok수거고,전면검색MRI대직장암술전방화료후재분기상관적영문문헌,검색일기1985년1월지2012년3월.대MRI용이직장암술전방화료후재분기적민감성화특이성진행Meta분석.결과 최종납입15편,공749례환자.MRI대직장암술전방화료후T3～T4분기진단적민감성위82.1％(95％CI:67.9％～90.9％),특이성위53.5％(95％CI:39.3％～67.3％),진단비수비(DOR)위5.34 (95％ CI:2.73～10.45);대양성림파결진단적민감성、특이성급DOR분별위61.8％ (95％CI:50.7％～71.8％)、72.0％ (95％CI:61.3％～80.7％)화4.33 (95％CI:2.84～6.59);대배주절연양성진단적민감성、특이성급DOR분별위85.4％ (95％CI:60.5％～95.7％)、80.0％(95％CI:57.4％～92.2％)화27.62(95％CI:13.03～58.55).결론 MRI대우직장암술전방화료후T3～T4화양성림파결진단준학성일반,이대배주절연진단준학성고.추천술전상규이용MRI대직장암환자진행방화료후재분기,이피면과도치료.
Objective To estimate the diagnostic accuracy of magnetic resonance (MR) in restaging of rectal cancer after preoperative chemoradiotherapy (CRT).Methods Comprehensive search of literature concerning the diagnosis of MR for rectal cancer after preoperative CRT was performed from databases of PubMed,EMbase,OVID and WOK.Sensitivity and specificity of MR on restaging of rectal cancer after preoperative CRT were investigated by SAS and MetaDiSc software.Results Thirteen articles including 749 patients were enrolled in this meta-analysis.For T3-T4 stage,sensitivity of MR was 82.1％(95％CI:67.9％-90.9％),specificity was 53.5％(95％CI:39.3％-67.3％),and diagnostic odds ratio (DOR) was 5.34 (2.73,6.59).For lymph node involvement,sensitivity of MR was 61.8％ (95％CI:50.7％-71.8％),specificity was 72.0％(95％CI:61.3％-80.7％),and DOR was 4.33 (95％CI:2.84-6.59).For circumferential resection margin (CRM) by MR,pooled sensitivity was 85.4％ (95％CI:60.5％-95.7％),specificity was 80.0％(95％CI:57.4％-92.3％),and DOR was 27.62 (95％CI:13.03-58.55).Conclusions Restaging accuracy of T3-T4 and lymph nodes involvement of rectal cancer after preoperative CRT by MR is not high.MR may be a good method to make reassessment of CRM.To avoid overtreatment for T0-T2,negative lymph node and circumferential resection of rectal cancer,restaging by MR after preoperative CRT is important.
