超声造影对浅表淋巴结良恶性鉴别的Meta分析

CONTRAST-ENHANCED ULTRASONOGRAPHY IN DIFFERENTIAL DIAGNOSIS OF BENIGN AND MALIGNANT SUPERFICIAL LYMPH NODES:A META-ANALYSIS

目的评价超声造影对浅表淋巴结良恶性鉴别的价值。方法检索中国知网、万方、维普、PubMed、Cohchrane library等数据库,由2名检索员依据纳入和排除标准对检索得到的文献进行筛选,参照诊断性试验准确性质量评价工具（QUADAS）条目对纳入的文献进行质量评价,采用Meta Disc 1.4Version软件对纳入文献的原始数据进行汇总和计算,进而评价超声造影在浅表淋巴结良恶性鉴别中的价值。结果共有18篇文献纳入研究,中文文献12篇,英文文献6篇。各样本之间异质性较高,亚组分析后剔除良恶性淋巴结个数之比〈1∶2的样本,剩余13个研究异质性较低,遂采用固定效应模型进行分析。汇总加权得到的合并灵敏度为0.88（95%CI=0.85~0.91）,合并特异度为0.86（95%CI=0.82~0.89）,阳性似然比为5.72（95%CI=4.58~7.14）,阴性似然比为0.15（95%CI=0.12~0.19）,诊断比值比为42.85（95%CI=29.87~61.46）,合并受试者工作特征曲线下面积为0.927 9,Q指数为0.868 2。结论超声造影对浅表淋巴结良恶性的鉴别具有较高的价值。

Objective To assess the value of contrast-enhanced ultrasonography（CEU）in differential diagnosis of benign and malignant superficial lymph nodes. Methods Databases of CNKI,Wanfang,Veipu,PubMed and Cohchrane library were retrieved.According to the inclusion and exclusion criteria,the retrieved documents were screened by two search members.Referencing QUADAS entries,the quality of included literatures were evaluated.Employing Meta Disc 1.4Version software,the original data included in the literatures were summarized and calculated,and the value of CEU in differential diagnosis of benign and malignant superficial lymph nodes was evaluated. Results A total of 18 articles were included in the study,12 in Chinese and six in English.After the samples with the ratio of benign and malignant lymph nodes of1∶2were removed,the rest 13 were with low research heterogeneity,a fixed effect model was then adopted for analysis.The combined sensitivity obtained from summary weighting was 0.88（95%CI=0.85-0.91）,combined specificity was 0.86（95%CI=0.82-0.89）,positive likelihood ratio was5.72（95%CI=4.58-7.14）,and negative likelihood ratio was 0.15（95%CI=0.12-0.19）,diagnostic accuracy and and odds ratio was 42.85（95%CI=29.87-61.46）,the area under ROC curve was 0.927 9,and Q index was 0.868 2. Conclusion Contrastenhanced ultrasonography has a higher value in differential diagnosis of benign and malignant superficial lymph nodes.