Diagnostic Performance Of Indocyanine Green Guided Sentinel Lymph Node Biopsy In Gastric Cancer:A Meta-Analysis

Objective: We performed a meta-analysis to investigate the diagnostic performance of ICG guided sentinel lymph node biopsy,and discussed the possible factors by subgroup analysis.Methods: Studies about ICG guided SLNB in gastric cancer in electronic databases PUBMED,EMBASE,and Cochrane Library were searched.Two independent evaluators screened the literature,evaluated the quality of the literature and extracted relevant data according to inclusion and exclusion criteria.Stata 15.0 was used to perform the meta analysis,effect size(sensibility,specificity and diagnostic odds ratio)and 95% confidence interval(95% CI)were calculated,the summarized receiver operator characteristic curve(SROC curve)was drawn and area under the curve(AUC)was calculated.We conducted subgroup analysis and sensitivity analysis to discuss the possible sources of heterogeneity and explored its influencing factors.Finally,Deek's funnel plot was drawn to calculate the publish bias.Results: A total of 14 studies were included.Meta-analysis results showed that the combined sensitivity of ICG guided SLNB in gastric cancer was 0.85(95%CI: 0.70-0.93),the combined specificity was 1.00(95%CI: 0.95-1.00),and the combined diagnosis odds ratio was 330.07.The AUC was 1.00(95%CI: 0.99-1.00),the critical value was at the sensitivity 0.85(95%ci: 0.70-0.93),and the specificity 1.00(95%ci: 0.95-1.00).Conclusions: We found encouraging results regarding the sensitivity,specificity and diagnostic odds ratio of the test.For patients with early gastric cancer,the sensitivity of diagnosis is higher.Meanwhile,submucosal injection and HE+IHC combined pathologic examination may have positive effects on improving diagnostic efficiency.However,given the unsatisfactory diagnostic sensibility,clinical application must be viewed with caution.