Sentinel Lymph Node Biopsy For Diagnosis Of Pelvic Or Abdominal Cavity Lymph Node Metastases In Early Stage Endometrial Cancer:A Diagnostic Meta-Analysis

Objective:This meta-analysis was conducted to evaluate the clinical diagnostic performance of SLNB in the assessment of pelvic or abdominal cavity lymph node involvement in early stage endometrial cancer.Methods:A comprehensive literature search on the electronic databases,such as PubMed,Embase,Cochrane Library and CNKI,VIP,CBM.Overall,1,100 studies were retrieved through the electronic databases searching.Reference articles of related literatures were also researched.Related literatures were published from January,01,2001 to December,31,2017.The language of studies was limited to English and Chinese only.There were 11 related studies were included and analyzed by Meta-analysis software MetaDisc 1.4.Results:A total of 11 studies were deemed as eligible by the authors(involving 1090 patients)after conducting a comprehensive and through literature search.According to different mapping method employed and the site of dye injection,we did a sub-group analysis.Meta-analysis showed that :1.The pooled sensitivity and specificity for sentinel lymph node biopsy in the diagnosis of early pelvic or abdominal cavity lymph node involvement were97%(95% CI: 93%–99%)and 90%(95% CI: 88%–92%),respectively.The total AUC was calculated the area under the SROC curve.The AUC of this research is 97.97% and Q* is 0.937.2.The pooled sensitivity of SLNB were 0.97(95%CI:0.85-1.00)、0.95(95%CI:0.77-1.00)、0.97(95%CI:0.91-1.00)in studies using radiotracer alone,blue dye alone and combined tracers,respectively.3.The pooled sensitivity of SLNB were 0.97(95%CI:0.91-1.00)、0.96(95%CI:0.87-1.00)in studies using cervical injection,uterine injection,respectively.Conclusions:The present results confirmed that sentinel lymph node biopsy is a feasible and reliable approach that performs well diagnostically for the assessment of lymph node metastasis in early stage endometrial cancer.We also found that SLNB using combine tracers demonstrated highest sensitivity,and radiotracer alone was higher than with blue dye alone.The use of cervical injection and the radiotracer of the mapping material can optimize the sensitivity and detection rate of the technique.