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利用超声内镜弹性成像区别良性和恶性淋巴结:一项荟萃分析

发布日期:2014-1-29 12:40:22 文章来源:GIE 作者次数:1197
    利用超声内镜弹性成像区别良性和恶性淋巴结:一项荟萃分析
     
    背景
    超声内镜弹性成像是一种通过描述靶组织力学性能来区分良性和恶性淋巴结(LNS)的新技术。
     
    目的
    通过汇总现有实验数据评估超声内镜弹性成像的准确性。
     
    设计
    实施七项研究,共涉及368例患者,其中431例恶性淋巴结。 我们运用荟萃分析在一个固定效应模型或随机效应模型中汇总实验数据。
     
    患者
    这项研究涉及368例患者。
     
    干预
    超声内镜弹性成像。
     
    主要结果测量
    荟萃分析和荟萃回归分析。
     
    结果
    利用超声内镜弹性成像鉴别诊断良性和恶性淋巴结,这种方法的敏感度为88%(95%可信区间[CI]为0.83-0.92),特异性为85%(95%可信区间为0.79-0.89)。综合受试者工作特征(SROC)曲线下面积为0.9456。合并阳性似然比为5.68(95%可信区间为2.86-11.28)和阴性似然比为0.15(95%可信区间为0.10-0.21)。 通过排除异常值的亚组分析得出了鉴别诊断良性和恶性淋巴结的敏感性为85%(95%可信区间为0.79-0.90),特异性为91%(95%可信区间为0.85-0.95),综合受试者工作特征曲线下面积为0.9421。
     
    局限性
    少数研究符合纳入标准
     
    结论
    超声内镜弹性成像是一种无创性地鉴别诊断恶性淋巴结的很有前途的方法,并可能是对超声内镜引导下细针穿刺的一种有价值的补充技术。
     
    缩写词:AUC为曲线下面积;CI为可信区间;EUS-FNA为超声内镜下引导细针穿刺;LN为淋巴结;LR为似然比;QUADAS为质量评估诊断的准确性;SROC为综合受试者工作特征。
     
     
     
    EUS elastography for the differentiation of benign and malignant lymph nodes: a meta-analysis
    Background
    EUS elastography is a new technique for differentiating benign and malignant lymph nodes (LNs) by describing the mechanical property of the target tissue.
    Objective
    To assess the accuracy of EUS elastography by pooling data of existing trials.
    Design
    Seven studies involving 368 patients with 431 LNs were included. Meta-analysis was performed. Pooling was conducted in a fixed-effect model or a random-effect model.
    Patients
    This study involved 368 patients.
    Intervention
    EUS elastography.
    Main Outcome Measurements
    Meta-analysis and meta-regression analysis.
    Results
    The pooled sensitivity of EUS elastography for the differential diagnosis of benign and malignant LNs was 88% (95% confidence interval [CI] 0.83-0.92), and the specificity was 85% (95% CI, 0.79-0.89). The area under the curve under summary receiver operating characteristic (SROC) was 0.9456. The pooled positive likelihood ratio was 5.68 (95% CI, 2.86-11.28), and the negative likelihood ratio was 0.15 (95% CI, 0.10-0.21). The subgroup analysis by excluding the outliers provided a sensitivity of 85% (95% CI, 0.79-0.90) and a specificity of 91% (95% CI, 0.85-0.95) for the differential diagnosis of benign and malignant LNs. The area under the curve under SROC was 0.9421.
    Limitations
    A small number of studies met inclusion criteria.
    Conclusion
    EUS elastography is a promising, noninvasive method for differential diagnosis of malignant LNs and may prove to be a valuable supplemental method to EUS-guided FNA.
    (作者:)
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