Pre-operative lymph node status of gastric cancer evaluated by multidetector computed tomography

Abstract

The purpose of the present study was to perform a meta-analysis to evaluate the diagnostic value of Multidetector computed tomography (MDCT) in the pre-operative lymph node (N) staging in gastric cancer (GC) patients. The Medline, Embase and Web of Knowledge were searched for studies assessing the diagnostic value of MDCT in the pre-operative evaluation of TNM staging in GC patients. We pooled the sensitivity, specificity, positive and negative Likelihood ratio (LR+ and LR-), Diagnostic Odds Ratio (DOR) and constructed summary receiver operating characteristic curves (ROC). A total of 30 studies including 6637 GC patients were analyzed. The pooled estimates of sensitivity, specificity, LR+, LR- and DOR of MDCT in the detection of pre-operative N staging in GC patients were 0.67 (95% CI: 0.66-0.69 ), 0.84 (95% CI: 0.83-0.85), 3.25 (95% CI: 2.69-3.93), 0.36 (95% CI: 0.28-0.46) and 10.31 (95% CI: 7.66-13.88), respectively. The results of a summary ROC showed that the AUC and Q* were 0.8338 and 0.7661, respectively. As a control, the AUC and Q* of endoscopic ultrasonography were 0.8063 and 0.7414, respectively. Currently, it is necessary to recommend the routine clinical application of MDCT in the preoperative evaluation of lymph node status in GC patients.

Keywords: MDCT; Multi-detector computed tomography; gastric cancer; lymph node staging; meta-analysis.

Figure 1

Flow chart of selection processes for eligible studies. MDCT, Multidetector Computed Tomography.

Figure 2

The forest plot and summary ROC curve of MDCT in evaluating pre-operative lymph node staging in gastric cancer patients are illustrated. (A-C) Showed the forest plot of pooled sensitivity (A), specificity (B) and Diagnostic Odds Ratio (C), respectively. (D) Revealed the summary ROC curve of MDCT. MDCT, Multidetector Computed Tomography; ROC, receiver operating characteristic.

Figure 3

The forest plot and summary ROC curve of EUS in evaluating pre-operative lymph node staging in gastric cancer patients are presented. (A-C) illustrated the forest plot of pooled sensitivity (A), specificity (B) and Diagnostic Odds Ratio (C), respectively. (D) Showed the summary ROC curve of EUS. ROC, receiver operating characteristic; EUS, endoscopic ultrasonography.