The value of ¹⁸FDG PET-CT in the diagnosis of mediastinal lymph node metastasis in non-small cell lung cancer: a Meta-analysis

Objective: To assess the diagnostic value of mediastinal lymph node in non-small cell lung cancer using PET-CT by Meta-analysis. Methods: Publications on mediastinal lymph node staging of non-small cell lung cancer by PET-CT published from January 2002 to January 2016 were filtered and assessed according to criteria from the PubMed, EMBASE, Cochrane library database. The number of true positive, false positive, false negative and true negative were extracted, meta-analysis was performed using STATA software, and receiver operating characteristic curve was applied, then area under the curve(AUC) was calculated. At last, heterogeneous sources were discussed and subgroup analyses were performed. Results: Twenty-three relevant literatures(2959 patients) were enrolled, the diagnostic sensitivity and specificity based on the patients were 0.66(0.55-0.75) and 0.84(0.79-0.89), AUC was 0.84 (0.80-0.87). The results of subgroup analysis suggested that pulmonary tuberculosis was one important factor that influenced the PET-CT diagnosis of mediastinal lymph node metastasis in NSCLC patients (P = 0.01). Conclusions: PET-CT has a high accuracy for the mediastinal lymph node staging in non-small cell lung cancer, and it is the recommended examination method in these patients. Patients who had suffered from pulmonary tuberculosis should be treated with caution. (authors)