Diagnostic Value Of Imaging Examination On The Staging Of Endometrial Cancer

Objective: Endometrial cancer is one of the malignant tumors of thefemale genital tract. The treatment of endometrial cancer is surgical stagingfollowed with radiotherapy and/or chemotherapy. Correct preoperativediagnostic is of great significance of surgical method of endometrial cancer.Currently, the preoperative diagnosis of endometrial cancer includes:pathological examination (fractional curettage, endometrial biopsy, etc.) andimaging examination (CT, MRI, ultrasound, PET, CT), etc. Imagingexamination is widely used because of less invasion. At present, domestic andforeign literatures on the diagnostic value of endometrial cancer staging islimited in number. In particular, prospective and randomized controlledclinical trials about the diagonostic value of imaging examination forendometrial cancer are lacked. To study and summarize the value of imageexamination for EC is of significance for the prevention, treatment andimproving the quality of life of patients.The present study aimed to compare the image(MRI, ultrasound, PET,CT) features with pathological data of EC patients by Meta-analysis，the coremethod of evidenced-based medicine, evaluate the diagonostic value of imageexamination for EC and contribute to the diagnosis and treatment of EC.Methods: A thorough literature search was performed amongOvid-medline, Pubmed, CNKI,CBMdisc,Wanfang,Weipu database throughinternet, aiming at the diagnostic tests about the diagonostic value ofimageexamination for EC. All the literatures are further selected by rigid criteriaformed in advance to include or exclude samples. The included literatureswere evaluated by the QUADAS quality of evaluation criteria and the2*2tables were extracted.All the data extracted was put in Stata12.0and Meta-disc1.4software and analyzed by them. Stata12.0was used to judge the publication bias andMeta-disc1.4to heterogeneity analysis, pooled sensitivity, pooled specificity,pooled positive likelihood ratio and pooled negative likelihood ratio. TheSROC (summary receiver operator characteristic curve) was drawn and thearea under the curve (AUC) was calculated with Meta-disc1.4.Results:1According to the inclusion and exclusion criteria of the study, sixliteratures were included, three in English and three in Chinese. Among the788cases totally,536cases received MRI examination and252cases got PETpreoperatively.2Meta-analysis results: for deep myometrial infiltration, pooledsensitivity, pooled specificity, pooled positive likelihood ratio, pooled negativelikelihood ratio and under the AUC was0.795,0.652,3.3480.274,0.8059respectively; for cervical stromal invasion, pooled sensitivity, pooledspecificity, pooled positive likelihood ratio, pooled negative likelihood ratio,and AUC was0.500,0.942,8.148,0.52,0.956respectively; for lymph nodemetastasis, pooled sensitivity, pooled specificity, positive likelihood ratio,pooled negative likelihood ratio and AUC was0.618,0.917,7.163,0.39,0.7892respectively.Conclusion: Image examination has a higher sensitivity and lowerspecificity for deep myometrial invasion of endometrial cancer and higherspecificity and lower sensitivity for cervical stromal invasion and lymph nodemetastasis. The accuracy of image examination is higher on the diagonosis ofcervical stromal invasion of the endometrial cancer patients with publicationbias and moderate on the diagonosis of deep myometrial invasion and lymphnode metastasis,but it is not adequate for the formulation.of surgical strategy.