Objective: To evaluate the accuracy of positron emission tomography/computed tomography (PET/CT) in the diagnosis of lymph node metastasis in non-small cell lung cancer (NSCLC) by a method of meta-analysis.
Materials and methods: A comprehensive search of PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Embase data bases was conducted to collect literature about PET/CT diagnosing lymph node metastasis of NSCLC up to December 1, 2021. Stata 15.0 software was used for the calculation of sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). The publication bias was evaluated by Deeks' funnel plot.
Results: A total of 25 studies were enrolled, including 2,458 patients with NSCLC. The pooled sensitivity of PET/CT for diagnosing lymph node metastasis in NSCLC was 0.68 (95%CI: 0.61-0.75), the pooled specificity being 0.93 (95%CI: 0.89-0.95). Likelihood ratio syntheses gave an overall PLR of 9.4 (95%CI: 6.3-13.9), and NLR of 0.34 (95%CI: 0.28-0.41). The pooled DOR was 28 (95%CI: 19-40). The summary receiver operating characteristic curve showed the area under the curve of 0.88 (95%CI: 0.84-0.90).
Conclusion: Positron emission tomography/CT has a good value in the diagnosis of lymph node metastasis of NSCLC, with specificity excellent. Positron emission tomography/CT can be used as one of the main imaging diagnosis methods for lymph node metastasis in patients with NSCLC.