超声“萤火虫”成像对乳腺癌诊断价值的Meta分析

Ultrasound MicroPure imaging in diagnosis ofbreast cancer:A Meta-analysis

目的用Meta分析评价超声“萤火虫”成像对乳腺癌的诊断价值。方法检索PubMed、Cochrane、知网、万方等数据库中的相关文献并根据纳入标准严格进行文献筛选及质量评价。采用Meta-Desc及Stata 16.0统计软件,检验异质情况并选择相应效应模型,获得敏感度、特异度及似然比的均值及95%可信区间,绘制SROC曲线并计算曲线下面积,最后进行偏倚分析。结果共纳入18篇文献,共1647个病例,1807个病灶。由于存在非阈值效应引起的异质性,固采用随机效应模型合并效应量,合并敏感度、特异度及SROC曲线下面积分别为83.00%(78.00%~87.00%),86.00%(81.00%~90.00%),0.91(0.88~0.93);合并诊断比值比(DOR)为29.00(17.00~51.00)。纳入文献较稳定,无明显发表偏倚(P=0.48>0.05)。结论Meta分析表明,超声“萤火虫”成像诊断乳腺癌的敏感度、特异度及准确率均较高,具有较高的临床应用价值。

Objective To evaluate the diagnosticvalue of ultrasound MicroPure imaging in breast cancer by Meta analysis.Methods The databases including PubMed,EMBASE,Web of science,Cochrane Library,China National Knowledge Infra‐structure(CNKI),Wanfang Data,CBM and VIP were searched comprehensively and screened respectively for the related articles from establishment to March 2022.The quality evaluation of the included articles was performed by QUADAS-2 which was used for judgement of the risk of bias and,the feature information was appraised and extracted.Simultaneously,the comprehensive evaluation was applied by Meta-Disc and Stata 16.0 statistical software.First of all,the heterogeneity was estimated and the corre‐sponding effect model was selected,and then the mean value of sensitivity,specificity and likelihood ratio and 95%confidence in‐terval were obtained,the area under the curve(AUC)of summary receive operating characteristic(SROC)was calculated,and fi‐nally the bias analysis was carried out.Results Including 18 articles,the studies had a total of 1647 cases and 1807 lesions.There was heterogeneity caused by non-threshold effect in the included studies.The random effects model analysis showed that the mean sensitivity and confidence interval(95%)was 83.00%(78.00%~87.00%),the mean specificity was 86.00%(81.00%~90.00%),and AUC was 0.91(0.88~0.93).The combined diagnostic odds ratio(DOR)was significant 29.00(17.00~51.00).The included articles were stable and the publication bias was not statistically significant(P=0.48>0.05).Conclusion Meta analysis indicates that ultrasound MicroPure imaging technology has not only higher sensitivity,but also higher specificity and accuracy in the diagnosis of breast cancer,which can provide valuable information particularly on breast cancer with calcification.