乳管镜与乳管造影对乳头溢液疾病诊断价值比较的meta分析

A diagnostic meta-analysis:fiberoptic ductoscope versus galactography for the diagnostic value of nipple discharge

目的:系统评价乳管镜检查及乳管造影对乳头溢液的诊断效能。方法:检索Cochrane图书馆(cochrane library,CL)对照试验注册资料库、循证医学数据库、Pub Med数据库、中国维普建库至今国内外关于乳管镜检查及乳管造影对乳头溢液诊断对比的文献。筛选出文献8篇,记录数据,用Meta分析的相关软件Metadisc1.4和Review Manager5.1进行统计学分析。结果:8项研究的患者共1 170例,meta分析结果:2种诊断的敏感度分别为82%和78%;特异度分别为51%和50%;SROC曲线下面积(AUC)分别为0.776和0.705,Q*值分别为0.715和0.657。2种检查方法的敏感度及特异度相似,差异不具有统计学意义。乳管镜的诊断效能大于乳管造影。结论:乳管内视镜对乳头溢液的病因诊断优于选择性乳管造影,可以取代乳管造影。

Objective To evaluate the diagnostic efficiency of fiberoptic ductoscope versus galactography for nipple discharge. Methods Literatures on comparing the diagnostic value of galactography with fiberoptic ductoseope （FDS） on the nipple discharge were searched from the Cochrane library, Evidence based medicine （EBM ）,PubMed,China Vip database, and 8 studies were intaked. Then the data was analyzed by software Metadisc1.4 and Review Manager5.1. Results There are 1170 patients in the 8 studies. The pooled estimates for sensitivity of FDS and galactography was 82%, 78%, and the pooled estimates for specificity was 51%, 50%, respectively. The weighted AUC （area under curve） was 0.776, 0.705, Q＊values was 0.715, 0.657, respectively. The sensitivities and specificity of the 2 methods were not significantly different. The overall diagnostic efficacy of FDS was better than that of galactography. Conclusion FDS is better than galaetography in the diagnostic value of nipple discharge.