The Accuracy Of18F-FDG PET/CT For Assessment Of Axillary Lymph Node Status In Breast Cancer: A Meta-analysis

Background: Breast cancer can make serious damage to women’s health. Theincidence of breast cancer has been at the lead in women’s malignant tumor in China.Axillary lymph node metastasis is an important factor for predicting both breast cancerrecurrence and patient survival. During the treatment of breast cancer, the sentinel lymphnode biopsy (SLNB) and axillary lymph node cleaning (ALND) are the most commonlyused methods to evaluate axillary lymph node status and they are also the gold standards.But there are complications, lymph edema disease may occur, for example. Positronemission tomography/computer tomography (PET/CT) has been widely used in clinicaloncology research in recent years. This study aims to analyze the value of18F-FDG PET/CTin the diagnosis of axillary lymph node status of breast cancer and provide theoretical basisfor clinical diagnosis and individualized treatment.Objective: In this report, the value of18F-FDG PET/CT in assessing the accuracy ofthe axillary lymph node status of breast cancer will be examined.Methods: We systematically searched PubMed (2001-2014.12), Web of science (2001-2014.12), The Cochrane Library (2001-2014.12), EMBASE.com (2001-2014.12), ChineseScientific Journal Full-text Database (2001-2014.12), WanFang Database (2001-2014.12),Chinese Sci-tech Periodical Full-text Database (2001-2014.12), Chinese BiomedicalLiterature Database (2001-2014.12), and supplemented by manual retrieval and track intoliterature references. In accordance with the formulated in advance into the exclusion criteriaincluded in the18F-FDG PET/CT in diagnosis of breast cancer axillary lymph node status ofrelated experimental study. Two researchers followed distinct rules and guidelines whenextracting the data for this research. This included the use of the QUADAS tool. The data was then thoroughly analysed and evaluated to assess its quality. When analysing the data itwas necessary to make use of the Meta-Disc1.4and STATA12.0software combinedsensitivity (SEN), specificity (SPE), positive likelihood ratio (+LR), negative quasilikelihood ratio (LR) and diagnostic odds ratio (are) and its95%confidence interval (95%CI), to map the receiver-operating characteristic curve (SROC curve) and calculate the areaunder the curve (AUC).Results: We searched for601records,27diagnostic tests and eventually met theeligible criteria, including3473patients. Meta analysis results show that the consolidation of18F-FDG PET/CT sensitivity, specific degrees and95%CI, AUC were0.59(95%CI:0.561,0.619),0.912(95%CI:0.898,0.925),0.835.Conclusion:1. PET/CT in assessing the state of axillary lymph node metastasis ofbreast cancer has high specific degrees, but the sensitivity is low. The difference is biggerbetween them.2.There is no evidence that18F-FDG PET/CT can replace SLNB and/orALND to evaluate axillary lymph node status of breast cancer.