Diagnostic accuracy of ≥ 16-slice spiral computed tomography for local staging of colon cancer: A systematic review and meta-analysis.

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.