Meta-Analysis
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2022; 10(19): 6483-6495
Published online Jul 6, 2022. doi: 10.12998/wjcc.v10.i19.6483
Diagnostic accuracy of ≥ 16-slice spiral computed tomography for local staging of colon cancer: A systematic review and meta-analysis
Dan Liu, Lin-Mei Sun, Jing-Hua Liang, Lei Song, Xiao-Pei Liu
Dan Liu, Lin-Mei Sun, Lei Song, Xi’an Hospital of Traditional Chinese Medicine, Xi’an 710021, Shaanxi Province, China
Jing-Hua Liang, Shenzhen Traditional Chinese Medicine Anorectal Hospital, Shenzhen 518000, Guangdong Province, China
Xiao-Pei Liu, School of Basic Medicine, Shaanxi University of Chinese Medicine, Xianyang 710021, Shaanxi Province, China
Author contributions: Liu D wrote the main manuscript and fully participated in all analyses; Liu D and Sun LM contributed to the study concept and design; Liang JH, Liu XP, and Song L participated in literature search, data extraction, and quality assessment; all authors read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lin-Mei Sun, MD, Xi’an Hospital of Traditional Chinese Medicine, No. 69 Fengcheng Eighth Road, Weiyang District, Xi’an 710021, Shaanxi Province, China. 15339183663@163.com
Received: August 19, 2021
Peer-review started: August 19, 2021
First decision: January 10, 2022
Revised: January 24, 2022
Accepted: May 27, 2022
Article in press: May 27, 2022
Published online: July 6, 2022
Processing time: 309 Days and 0.4 Hours
Abstract
BACKGROUND

Colorectal cancer is one of the most common cancers worldwide with high mortality and is classified as a single entity, although colon cancer and rectal cancer have largely different diagnoses, treatments, surgical methods, and recurrence rates. ≥ 16-slice spiral computed tomography (SCT) is mostly applied to detect the local stage of colon cancer; however, its diagnostic accuracy and whether it is conducive to distinguishing between high-risk and low-risk colon cancer are unclear.

AIM

To systematically review the diagnostic accuracy of ≥ 16-slice SCT for local staging of colon cancer.

METHODS

Based on the PubMed, EMBASE, Cochrane Library, and Web of Science databases, computers were used to search the literature from the establishment of the database to April 2021, and the results of the diagnostic tests on ≥ 16-slice SCT for local staging of colon cancer were collected according to the inclusion criteria. The data were then extracted and assessed on the basis of the Quality Assessment Checklist of the Institute of Economics of Canada, Reference Citation Analysis (https://www.referencecitationanalysis.com/). Afterward, a meta-analysis was performed using the statistical software Meta-disc 14.0 and Stata 15.0.

RESULTS

Eleven studies that provided data on 1613 subjects with computed tomography diagnostic tests were included in this study. Meta-analysis revealed that the pooled sensitivity, pooled specificity, pooled negative likelihood ratio (LR), pooled diagnostic odds ratio, and area under the fitted receiver operating characteristic (ROC) curve of ≥ 16-slice SCT for colon cancer T staging were 0.67 (95%CI: 0.65-0.70), 0.81 (95%CI: 0.80-0.83), 4.13 (95%CI: 2.66-6.41), 0.39 (95%CI: 0.31-0.49), 10.81 (95%CI: 7.33-15.94), and 0.829, respectively, while the specificity, negative LR, diagnostic odds ratio, and area under the fitted ROC curve of ≥ 16-slice SCT for N staging of colon cancer were 0.54 (95%CI: 0.49-0.59), 0.74 (95%CI: 0.70-0.77), 1.92 (95%CI: 1.36-2.70), 0.67 (95%CI: 0.51-0.87), 3.74 (95%CI: 1.76-7.94), and 0.829 respectively. The sensitivity and specificity of ≥ 16-slice SCT for colon cancer T staging were acceptable, while the sensitivity for colon cancer N staging was relatively low, though its specificity was acceptable.

CONCLUSION

≥ 16-slice SCT for local staging of colon cancer has good diagnostic value; however, the accuracy needs to be confirmed by further clinical practice.

Keywords: ≥ 16-detector CT; Diagnostic; Colon cancer; Systematic review; Meta-analysis

Core Tip: This systematic review and meta-analysis were based on eleven studies on 1613 patients with computed tomography diagnostic tests. The results indicated that ≥ 16-slice spiral computed tomography, which is most applied in clinical practice, displayed acceptable diagnostic accuracy and good diagnostic value for detecting the local stage of colon cancer. In addition, it is conducive to distinguishing between high-risk and low-risk colon cancer.