核磁共振成像和钼靶X线对中国乳腺癌诊断准确性的Meta分析

Diagnostic accuracy of MRI and X-ray for breast cancer in China:a Meta analysis

目的评价核磁共振成像(Magnetic Resonance Imaging,MRI)和钼靶X线(Molybdenum target X-ray,X线)对中国乳腺癌诊断的准确率。方法:系统检索维普数据库、万方学术期刊数据库和中国期刊全文数据库中关于MRI和X线对中国乳腺癌诊断准确性的文献,检索时限均为从建库至2014年6月。采用Revman 4.2软件对符合条件的文献进行Meta分析,各研究之间进行异质性检验,使用固定效应模型计算合并OR值和95%可信区间(CI),并用漏斗图查看发表偏倚。结果:共检索出582篇有关MRI和X线对中国乳腺癌诊断准确性的文献,其中28篇文献符合纳入标准,包含3 804例试验对象,其中MRI组1 902例,X线组1 902例。Meta分析结果显示,合并OR=3.52,95%CI(2.89,4.29),MRI组对中国乳腺癌诊断的准确性是X线组的3.52倍,差异有统计学意义(P<0.05)。漏斗图显示图形基本对称。结论 MRI和X线这两种检查方法在中国乳腺癌诊断准确性方面差异存在统计学意义,乳腺癌经MRI诊断的准确性是经X线的3.52倍。

Objective To evaluate the diagnostic accuracy of MRI and X-ray for breast cancer in China. Methods Databases including VIP,Wanfang Database,and CNKI were systematically searched for the articles on the diagnostic accuracy of MRI and X-ray for breast cancer in China from the date of establishment of the databases to June 2014. The extracted data were analyzed with Revman 4. 2 software and Chi-square for heterogeneity test. Fixed effect model was used to calculate combined OR value and 95% confidence interval（ CI）.Funnel plot was used to show statistical bias. Results A total of 582 articles on the diagnostic accuracy of MRI and X-ray for breast cancer in China were retrieved,28 articles met the inclusion criteria,including 3 804 cases,1 902 cases in MRI group and 1 902 cases in X-ray group. Meta analysis showed that the combined OR value was 3. 52,95% CI was 2. 89-4. 29,the diagnostic accuracy for breast cancer in China of MRI group was 3. 52 times more than that of X-ray group（ P〈0. 05）. Funnel plot revealed no significant publication bias. Conclusion There was statistically significant difference in diagnostic accuracy of breast cancer in China between MRI and X-ray,the diagnostic accuracy of breast cancer by MRI was 3. 52 times more than that of X-ray.