超声、钼钯、MRI对乳腺癌诊断价值的Meta分析

Value of Ultrasonography,Mammography and Magnetic Resonance Imaging in Diagnosis of Breast Cancer:A Meta-analysis

目的采用Meta分析法评价超声、钼钯、MRI对乳腺癌的临床诊断价值。方法检索CochraneLibrary、MEDLINE、EMBASE、CBM、CNKI、维普数据库中有关超声、钼钯、MRI对乳腺癌诊断相关文献,按照纳入排除标准筛选,所有纳入研究均进行质量评价及提取相关信息,采用Meta-disc 1.4软件进行Meta分析。结果共纳入9篇文献1、370个病灶,异质性检验结果:超声、MRI敏感度不存在异质性,选用固定效应模型合并;超声、MRI其他效应指标及钼钯均提示存在异质性,选用随机效应模型合并。结果显示超声、钼钯、MRI敏感度分别为84%7、5%9、5%,特异度为70%、71%、66%,SROC曲线下面积为:86.6%、81.6%、95.8%、超声+钼钯+MRI98.6%。Meta回归分析发现年龄是超声异质性来源,有无按BI-RADS标准是钼钯异质性来源,MRI未发现异质性来源。结论超声、钼钯、MRI对乳腺癌均具有较高诊断价值,三者联合诊断价值最高。

Objective To compare the value of ultrasonography （ US）, mammography （ MAM ） and magnetic resonance imaging（MRI） in the diagnosis of breast cancer with Meta-analysis. Methods Articles reporting US, MAM and MRI data of patients with known or suspected breast cancers were searched in the Cochrane Library, MEDL INE, EMBASE,CBM, CNKI, VIP. Study quality was assessed and data extraction was performed. Statistic analysis was performed with Meta-disc 1.4 software. Results Nine articles involving 1370 lesions were included in this Meta-analysis. Significant heterogeneity was present except the sensitivity of US and MRI in these studies. The fixed effect model and random effect model were both correspondingly used. Sensitivities of US ,MAM,MR.I were 84% ,75% ,95% and speciiicities were 70% ,71% and 66% respectively. Area under the curve （AUC） of summary receiver operating characteristic （SROC） curve were 86.6% ,81.6% ,95.8% respectively＇. AUC of combined diagnosis using the three methods together was 98.6%. In the Meta-regression analysis,covariate of age was associated with US,as well as BI-RADS with MAM. Conclusion US, MAM and MRI are valuable diagnostic methods for breast cancer,but the combination of these three methods is greatest valuable.