| ObjectiveTo systematically evaluate the accuracy of double-tracer versus single-tracer for locating sentinel lymph nodes after neoadjuvant chemotherapy in breast cancer.MethodsPUBMED,EMBASE,Wanfang database knowledge platform,China Journal full-text Database were searched.The database was established until January 2019.The clinical study on the application of double-tracer and single-tracer in sentinel lymph node biopsy after neoadjuvant chemotherapy for breast cancer was included.The detection rate,false negative rate,true positive,false positive,true negative and false negative data of double-racer group and single-tracer group were extracted and analyzed by meta.The included studies were analyzed by meta using Stata12.0,the odds ratio of detection rate and false negative rate(OR)was calculated,the quality of the included literature was evaluated by QUADAS-2 evaluation tool,the publication bias was evaluated by funnel chart,and the heterogeneity of each study was evaluated by Q test and I~2statistics.The sensitivity,specificity,positive likelihood ratio(PLR),negative likelihood ratio(NLR),diagnostic odds ratio(DOR),receiver working characteristic curve(SROC),area under SROC curve and Q index of the two methods were analyzed by Meta Disc1.4.ResultsA total of 15 clinical studies were included,with a total of 3436 subjects.The results were as follows:compared with single-tracer,double-tracer significantly increased the detection rate of SLN(OR=1.86,95%CI:1.44-2.42,P=0.000)and decreased the false negative rate(OR=0.53,95%CI:0.35-0.80,P=0.002).In terms of diagnostic efficacy,the combined results of double-tracers showed a sensitivity of89%(0.80-0.95)and a specificity of 100%(0.91-1.00),PLR was 24.91(4.69-132.37),NLR was 0.14(0.08-0.25),DOR was 160.22(27.42-936.33),AUC was 0.9742,Q index was 0.9268.The results of single-tracer combination showed that the sensitivity was 82%(0.75-0.88)and the specificity was 96%(0.90-0.99),PLR was15.95(3.31-76.81),NLR was 0.19(0.07-0.50),DOR was 98.09(8.08-1190.93),AUC was 0.9626,Q index was 0.9083.ConclusionCompared with single-tracer,double-tracer can improve the accuracy of sentinel lymph node biopsy after neoadjuvant chemotherapy in breast cancer. |
