超声判断甲状腺结节良恶性的Meta分析

A Meta-analysis of ultrasound in diagnosis of benign and malignant thyroid nodules

目的探讨应用彩色多普勒超声诊断甲状腺结节性质的敏感性、特异性诊断效能及临床应用价值。方法采用系统评价的方法 2015年4月~2015年8月网络检索中英文数据库Medline、EMBASE、Cochrane、CBM、中国期刊全文数据库CNKI和万方等。全面收集公开发表的关于彩色多普勒超声对甲状腺结节良恶性诊断的临床诊断试验,应用stata12.0统计软件进行meta分析,综合评价其诊断甲状腺恶性结节的敏感性、特异性、阳性似然比、阴性似然比和诊断的ROC曲线下面积。结果根据纳入与排除标准,最终有8篇文献纳入本研究,共4404例受试者参加本研究,系统分析的结果显示彩色多普勒超声诊断甲状腺结节性质的敏感性为0.80（95%CI：0.77~0.84）、特异性为0.87（95%CI：0.86~0.88）、阳性似然比为5.14（95%CI：3.51~7.52）、阴性似然比为0.25（0.14~0.43）、诊断优势比为26.9（95%CI：16.4~44.2）诊断的ROC曲线下面积为0.84。结论彩色多普勒超声判断甲状腺结节性质的敏感性特异性较高是临床上诊断甲状腺癌的可靠无创方法。

Objective To explore diagnostic efficacy and clinical applicative value of color doppler ultrasonography in diagnosis of sensitivity and specificity of benign and malignant thyroid nodules. Methods Chinese-English Database such as Medline,EMBASE,Cochrane and CBM,Chinese Journal Full Text Database CNKI,Wan fang and so on were searched form April 2015 to August 2015 by systematic review.Published clinical diagnosis trials about color doppler ultrasonography in diagnosis of benign and malignant thyroid nodules were comprehensively collected to comprehensively evaluate sensitivity,specificity,positive likelihood ratio,negative likelihood ratio and area under ROC curve by meta-analysis of stata12.0 statistical software. Results According to inclusion and exclusion criteria, 8 literatures were included in this research and 4404 subjects participated in it. Results of systematic analysis showed that sensitivity, specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio and area under ROC curve of color doppler ultrasonography in diagnosis of sensitivity and specificity of benign and malignant thyroid nodule were 0.80（95% CI：0.77-0.84）,0.87（95% CI：0.86-0.88）,5.14（95% CI：3.51-7.52）,0.25（0.14-0.43）,26.9（95% CI：16.4-44.2） and 0.84 respectively. Conclusion Application of color doppler ultrasonography in diagnosis of sensitivity and specificity of benign and malignant thyroid nodules is a reliable and non-invasive method to diagnose thyroid carcinoma in clinic.