title: Pre-operative TNM staging of primary colorectal cancer by (18)F-FDG PET-CT or PET: a meta-analysis including 2283 patients.
abstract: The aim of the present study was to perform a meta-analysis to assess the diagnostic value of fluorine-18 fluorodeoxyglucose ((18)F-FDG) PET-CT/PET in the pre-operative evaluation of TNM staging in patients with primary colorectal cancer (CRC). The Medline, Embase and Web of Knowledge were searched for studies assessing the diagnostic value of (18)F-FDG PET-CT/PET in the pre-operative evaluation of TNM staging in CRC patients. We pooled the sensitivity, specificity, positive and negative Likelihood ratio (LR+ and LR-) and Diagnostic Odds Ratio (DOR) and constructed summary receiver operating characteristic curves. A total of 28 studies including 2283 CRC patients were analyzed. The pre-operative tumor detecting rate of PET-CT was 95.35%, which was superior to CT (P < 0.05). The pooled sensitivity and specificity of pre-operative T staging by PET-CT/PET was 0.73 (95% CI: 0.65-0.81) and 0.99 (95% CI: 0.98-0.99), which the AUC and Q* were 0.96 and 0.91, respectively. Concerning pre-operative N staging, the pooled sensitivity and specificity of PET-CT/PET were 0.62 and 0.70, which the AUC and Q* were 0.76 and 0.70, respectively. As for M staging, the pooled sensitivity and specificity of PET-CT/PET were 0.91 (95% CI: 0.80-0.96) and 0.95 (95% CI: 0.91-0.98), which the AUC and Q* were 0.96 and 0.91, respectively. (18)F-FDG PET-CT/PET had good performance in the pre-operative tumor detecting rate, T staging and M staging in patients with primary CRC, which might alter the therapeutic strategy. However, the diagnostic value of (18)F-FDG PET-CT/PET in pre-operative N staging in CRC patients was not ideal.
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou, China; Institute of Clinical Medicine, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou, China.
authors.forename: Yanwei
authors.initials: Y
authors.lastname: Ye
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou, China; Institute of Clinical Medicine, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Liu
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Zhengzhou University Zhengzhou, China.
authors.forename: Lisha
authors.initials: L
authors.lastname: Lu
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou, China; Institute of Clinical Medicine, The First Affiliated Hospital of Zhengzhou UniversityZhengzhou, China.
authors.forename: Guojun
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Function, The Fifth Affiliated Hospital of Zhengzhou University Zhengzhou, China.
authors.forename: Min
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University Zhengzhou, China.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University Zhengzhou, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Han
authors.affiliation: Institute of Clinical Medicine, The First Affiliated Hospital of Zhengzhou University Zhengzhou, China.
authors.forename: Jianguo
authors.initials: J
authors.lastname: Wen
keywords: 18F-FDG-PET; Colorectal cancer; PET-CT; TNM staging; meta-analysis