title: Meta-analysis study of lymph node staging by 18 F-FDG PET/CT scan in non-small cell lung cancer: comparison of TB and non-TB endemic regions.
abstract: Lymph node staging in non-small cell lung cancer (NSCLC) is challenging and important for deciding treatment policy. The role of PET/CT scans in lymph node staging of NSCLC remains controversial when comparing TB and non-TB endemic regions. This study systematically reviews the literature regarding the diagnostic performance of PET/CT in lymph node staging of patients with NSCLC, and determines its pooled sensitivity and speciﬁcity.
  
  
  METHODS
  The databases of PubMed, Medline, and Cochrane library were searched for relevant studies. Two reviewers independently assessed the methodological quality of each study. A meta-analysis of the reported sensitivity and speciﬁcity of each study was performed.
  
  
  RESULTS
  Seven of 86 studies were included. These studies had moderate to good methodological quality. Pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio for patient-based analyses (five studies) were 66%, 92.7%, 5.86%, and 0.41%, respectively, and those for lesion-based analyses (six studies) were 59.4%, 96.5%, 9.37%, and 0.31%, respectively. Subanalysis of endemic regions of tuberculosis (TB) showed that these regions had lower sensitivity and similar specificity to non-TB endemic regions.
  
  
  CONCLUSIONS
  PET/CT showed high specificity in the lymph node staging of NSCLC and lower sensitivity in TB endemic regions.
authors.affiliation: Department of Radiation Therapy and Oncology, Taichung Hospital, Department of Health, Executive Yuan, Institute of Integrated Medicine, China Medical University, Taichung, Taiwan. jine871@yahoo.com.tw
authors.forename: Chih-Ying
authors.initials: CY
authors.lastname: Liao
authors.forename: Jin-Hua
authors.initials: JH
authors.lastname: Chen
authors.forename: Ji-An
authors.initials: JA
authors.lastname: Liang
authors.forename: Jun-Jun
authors.initials: JJ
authors.lastname: Yeh
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000453:epidemiology / Q000556:secondary*; D015897:Comorbidity; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008207:Lymphatic Metastasis; D008297:Male; D064847:Multimodal Imaging / Q000706:statistics & numerical data*; D009367:Neoplasm Staging / Q000706:statistics & numerical data; D049268:Positron-Emission Tomography; D015995:Prevalence; D019275:Radiopharmaceuticals; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18