Pre-operative lymph node status of gastric cancer evaluated by multidetector computed tomography

The purpose of the present study was to perform a meta-analysis to evaluate the diagnostic value of Multidetector computed tomography (MDCT) in the pre-operative lymph node (N) staging in gastric cancer (GC) patients. The Medline, Embase and Web of Knowledge were searched for studies assessing the diagnostic value of MDCT in the pre-operative evaluation of TNM staging in GC patients. We pooled the sensitivity, specificity, positive and negative Likelihood ratio (LR+ and LR-), Diagnostic Odds Ratio (DOR) and constructed summary receiver operating characteristic curves (ROC). A total of 30 studies including 6637 GC patients were analyzed. The pooled estimates of sensitivity, specificity, LR+, LR- and DOR of MDCT in the detection of pre-operative N staging in GC patients were 0.67 (95% CI: 0.66-0.69 ), 0.84 (95% CI: 0.83-0.85), 3.25 (95% CI: 2.69-3.93), 0.36 (95% CI: 0.28-0.46) and 10.31 (95% CI: 7.66-13.88), respectively. The results of a summary ROC showed that the AUC and Q* were 0.8338 and 0.7661, respectively. As a control, the AUC and Q* of endoscopic ultrasonography were 0.8063 and 0.7414, respectively. Currently, it is necessary to recommend the routine clinical application of MDCT in the preoperative evaluation of lymph node status in GC patients.