A Diagnostic Meta-analysis Of Sentinel Lymph Node Biopsy For Diagnosis Of Lymph Node Metastases In Early Stage Cervical Cancer

Objective:Evaluating the clinical value of SLNB for diagnosing pelvic lymfh node metastases in early stage cervical cancer through various tracer methods.Methods:Searching Pubmed,Elsevier,Wiley,OVID,Embase,Cochrane,Google Scholar,CJFD,CBM,CNKI,VIP,WANFANG to find related studies published in the period from January 1995 to November 2017.Accoding to the inclusive and exclusive strategies the studies were filtered to identify the desirable results and organize the data which was analysed by the Stata14.0 software.Results:According to the retrieval scheme 2612 literatures were obtained,46 of which were eligible for analysis.Those 46 literatures included 50 studies and 2983 early stage cervical cancer patients(FIGO IA1-IIA).There was no significant heterogeneity,so that the data could be merged.The pooled sensitivity and specificity were 0.90(95%CI: 0.84-0.94)?0.99(95%CI: 0.98-1.00);AUC of SROC was 0.98(95%CI: 0.96-0.99).Subgroup was firtly set according to different tracer methods and the sensitivity and specificity of blue and other dye alone were 0.96(95%CI: 0.78-0.99)?0.98(95%CI: 0.91-1.00),the AUC of SROC was 0.99(95%CI 0.98-1.00);the sensitivity and specificity of radio tracer alone were 0.95(95%CI: 0.87-0.98)?1.00(95%CI: 0.90-1.00),the AUC of SROC was 0.95(95%CI 0.93-0.97);the sensitivity and specificity of combined tracers were 0.86(95%CI: 0.77-0.91)?0.99(95%CI: 0.96-1.00),the AUC of SROC was 0.95(95%CI 0.93-0.97)?Then subgroup was set according to different FIGO stages,the sensitivity and specificity of IA1-IB1 were 0.89(95%CI: 0.70-0.97)?1.00(95%CI: 0.93-1.00),the AUC of SROC was 0.96(95%CI 0.94-0.98);the sensitivity and specificity of IB1-IIA were 0.95(95%CI: 0.79-0.99)?0.99(95%CI: 0.87-1.00),the AUC of SROC was 0.99(95%CI 0.97-0.99).Conclusions:SLNB is a significantly efficient method of diagnosis of lymph node metastases in early stage cervical carcinoma.SEN and SPE of combined tracers subgroup was a little lower than other two,while SPE of radio tracer alone was the highest one.At the same time,SLNB was more sensitive for IB1-IIA patients than IA1-IB1 patients,whilst their specificity was similar.