动态增强磁共振对前列腺癌术后复发或残留诊断的Meta分析

Diagnostic value of dynamic contrast-enhanced magnetic resonance imaging in the detection of residual or recurrent prostate cancer after radical prostatectomy: A meta-analysis

目的：评价动态增强磁共振（dynamic contrast—enhanced MRI，DCE—MRI）对前列腺癌（PCa）手术治疗后局部复发或残留的诊断效能。方法：检索PubMed、EMBASE、Cochrane Library、SCI、中国生物医学文献数据库（CBM）、中国期刊全文数据库（CNKI）、中文科技期刊数据库（VIP）、万方数字化期刊群等数据库，再根据已发表文献中的参考文献追溯进行手工检索。检索时间截止到2013年6月6日。依据纳入排除标准筛选文献，参照QUADAS评价纳入研究的质量并提取数据，利用Meta—Disc1．4软件进行统计分析，计算总敏感度、特异度、诊断比值比（d0R）及其95％可信区间（95％CI）和SROC曲线下面积（AUC）。结果：检索得到118篇文献，有7篇文献（12项研究）符合纳入标准。对12项研究进行Meta分析，总敏感性为0．88（95％CI：0．84～0．91），总特异性为0．87（95％CI：0．81～0．92），dOR为50．4（95％CI：26．0～97．6）。DCE—MRI对PCa术后复发或残留诊断的SROCAUC为0．9391，Q。指数为o．8764。结论：动态增强磁共振对诊断前列腺癌治疗后局限性复发或残留具有较高的敏感性与特异性，其中DCE与磁共振波谱（magnetic resonance spectroscopy，MRS）联合诊断效能更高。

Objective： To determine the diagnostic pertbrmance ot dynamic contrast-enhanced MKI （DISE-MKI） m paUents witn recurrent or residual prostate cancer after radical prostatectomy. Methods： Studies were systematically searched in the PubMed, EMBASE, Cochrane library, SCI, CBM, CNKI, VIP, WanFang, and other databases. Additional studies were manually searched using the references of the retrieved articles. The retrieved deadline time was June 6th, 2013. Studies were eligible for inclusion based on the inclusion and exclusion criteria, and the qualities of the studies were reviewed based on the QUADAS criteria. The Meta Disc 1.4 software was used for meta-analysis, and a summary receiver operating characteristic （SROC） curve was constructed. The patient - based pooled weighted estimates of the sensitivity, specificity, diagnostic odds radio, and 95% confidence interval were calculated. Results： Among the 118 eligible studies, 7 articles （12 studies） were included in the meta-analysis. The pooled weighted estimates of the sensitivity, specificity, and the area under the curve were 0.88 （95% confidence interval： 0.84 and 0.91）, 0.87 （95% confidence interval： 0.81 and 0.92）, and 0.939 1, respectively. The pooled diagnostic radio （dOR） was 50.4 （95% confidence interval： 26.0 and 97.6） and Q＊ was 0.876 4. Conclusion： DCE-MRI has high sensitivity and specificity in the evaluation of locally recurrent or residual prostate cancer after radical prostatectomy, in which the diagnostic efficiency of DCE-MRI combined with magnetic resonance spectroscopy is much better.