中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (30): 5569-5572.doi: 10.3969/j.issn.1673-8225.2011.30.015

• 骨与关节循证医学 evidence-based medicine of the bone and joint • 上一篇    下一篇

18FDG-PET术前评估骨与软组织肿瘤治疗效果的Meta分析

姬  涛1，朱赛楠2，郭  卫1，汤小东1，唐  顺1   

  1. 1北京大学人民医院骨与软组织肿瘤治疗中心，北京市 100044
    2北京大学第一医院医学统计室，北京市  100034
  • 收稿日期:2011-02-26 修回日期:2011-05-14 出版日期:2011-07-23 发布日期:2011-07-23
  • 通讯作者: 郭卫，教授，博士生导师，北京大学人民医院骨与软组织肿瘤治疗中心，北京市 100044 bonetumor@163.com
  • 作者简介:姬涛☆，男，1980年生，黑龙江省哈尔滨市人，汉族，2009年北京大学医学部毕业，博士，主治医师，主要从事骨与软组织肿瘤临床与基础研究。 sarcomasurgeon_cn@yahoo.com.cn

Meta analysis of 18F-deoxyglucose-positron emission tomography value in evaluation of response to therapy for primary bone and soft tissue sarcomas

Ji Tao1, Zhu Sai-nan2, Guo Wei1, Tang Xiao-dong1, Tang Shun1   

  1. 1Musculoskeletal Tumor Center, People’s Hospital, Peking University, Beijing  100044, China
    2Department of Statistics, Peking University First Hospital, Beijing  100034, China
  • Received:2011-02-26 Revised:2011-05-14 Online:2011-07-23 Published:2011-07-23
  • Contact: Guo Wei, Professor, Doctoral supervisor, Musculoskeletal Tumor Center, People’s Hospital, Peking University, Beijing 100044, China bonetumor@163.com
  • About author:Ji Tao☆, Doctor, Attending physician, Musculoskeletal Tumor Center, People’s Hospital, Peking University, Beijing 100044, China sarcomasurgeon_cn@yahoo.com.cn

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摘要：

背景：18FDG-PET可为骨和软组织肿瘤的良恶性鉴别，病变定位，恶性程度评价，活检部位的确定，治疗效果评估和判断预后提供重要信息。
目的：采用Meta分析方法评价18FDG-PET在术前骨与软组织肿瘤治疗疗效评估方面的应用价值。
方法：检索PubMed、EMBASE、Cochrance、CNKI、万方数据库及维普中文科技期刊数据库获得PET用于骨与软组织肿瘤诊治方面的临床研究。
结果与结论：对符合纳入标准的9项临床非随机对照研究进行Meta分析，文献质量评价循证医学推荐级别3项研究为B级，6项为C级，检验提示无发表偏倚。将治疗前后最大标准摄取值SUV2/SUV1≤0.5作为预测术后肿瘤坏死率≥90%的敏感性和特异性分别为0.82(95%CI，0.72~0.89)和0.61(95%CI，0.49~0.71)。SROC为6.17(95%CI，2.84~13.39)。说明将化疗前后最大标准摄取值比值作为评价术前疗效的敏感性较好，但缺乏特异性；应综合18FDG-PET检查结果与其他辅助检查结果对术前疗效进行综合评估。

关键词: 软组织肉瘤, 骨肿瘤, FDG-PET, 诊断价值, Meta分析

Abstract:

BACKGROUND: 18 F-deoxyglucose-positron emission tomography (18FDG-PET) can be used for bone and soft tissue malignant tumor identification, lesion location, degree of malignancy evaluation, biopsy site identification, effect and prognostic assessment.
OBJECTIVE: To assess the value of 18FDG-PET in the evaluation of preoperative therapy response of bone and soft tissue sarcomas by systematic review and meta-analysis.
METHODS: Databases of PubMed, Embase, Cochrane, CNKI, WanFang and VIP databases were searched for articles about PET application in diagnosis and treatment of bone and soft tissue malignant tumor.
RESULTS AND CONCLUSION: Nine non-randomized controlled clinical studies which met the inclusion criteria were included for Meta analysis. Qualitative analysis found recommendation grade B in three studies and C in seven studies. No bias was found in the nine studies. Pooled sensitivity and specificity of cut point 0.5 (SUV2/SUV1) for the prediction of tumor necrosis ≥ 90% were 0.82 (95% confidence interval, 0.72-0.89) and 0.61 (95% confidence interval, 0.49-0.71) respectively. The summary receiver operating characteristic curve (SROC) was 6.17 with 95% confidence interval of 2.84-13.39. Our results indicate that the SUVmax ratio before and after preoperative treatment can predict therapy response with compared high sensitivity, however lack of specificity. Evaluation of preoperative therapy should be determined with combination of 18FDG-PET and others.

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