甲状腺冷结节^(99m)Tc-MIBI显像诊断甲状腺癌的Meta分析

Meta Analysis on ^(99m)Tc-MIBI Scintigraphy of Cold Thyroid Nodule in Diagnosis for Thyroid Cancer

[目的]通过Meta分析综合评价甲状腺冷结节99mTc-MIBI显像诊断甲状腺癌的价值,并比较观察法与定量/半定量法的准确性。[方法]检索万方、维普、中国知网CNKI数据库中研究甲状腺冷结节99mTc-MIBI显像诊断甲状腺癌的文献,按照循证医学诊断性试验的标准筛选文献。用MetaDisc1.4软件合并纳入的试验结果,并绘制SROC曲线。[结果]观察法组纳入病例数为803例,合并灵敏度、特异度及加权SROC曲线下面积(AUC)分别为83.2%、78.2%、0.8904,定量/半定量法组纳入病例数为471例,上述各值分别为81.6%、90.0%、0.9273。[结论]甲状腺冷结节99mTc-MIBI显像对甲状腺癌的诊断具有较高价值。观察法和定量/半定量法灵敏度相接近,后者的特异度高,对甲状腺癌的诊断准确性更高。

[Purpose] To assess the value of the cold thyroid nodule ^99mTc-MIBI scintigraphy in diagnosing thyroid cancer by Meta-analysis, and to compare the diagnostic accuracy of observation method （OM） and quantitative/semiquantitative method （QSM）. [Method] Wanfang,Vip and CNKI database were searched for literatures related to the cold thyroid nodule ^99mTc-MIBI scintigraphy in diagnosing thyroid cancer. The literatures were assessed and screened according to the standards for diagnostic test of evidence-based medicine. Data were pooled and summary receiver operating characteristic （SROC） curve was drawn by MetaDisc1.4 software. [Result] Of the 803 cases in OM group, the pooled sensitivity, specificity and the AUC of weighted summary receiver operating characteristic （SROC） curve were 83.2%, 78.2% and 0.8904 respectively. Of the 471 cases in QSM group those were 81.6%, 90.0% and 0.9273 respectively. [Conclusion] The cold thyroid nodule ^99mTc-MIBI scintigraphy plays a role in diagnosing thyroid cancer. OM and QSM have similar sensitivity. The later has higher specificity and accuracy in diagnosing thyroid cancer.