超声引导下粗针穿刺对比细针穿刺在甲状腺结节诊断准确性及安全性的Meta分析

Diagnostic accuracy and safety of US-guided core needle biopsy versus fine-needle aspiration biopsy of thyroid nodules:a Meta analysis

目的:系统评价粗针穿刺(CNB)与细针穿刺(FNAB)在诊断甲状腺结节中的准确性和安全性。方法:计算机检索中国知网(CNKI)、万方数据库、中国生物医学文献数据库(CBM)、PubMed、Cochrane Library、EMBASE、Web of Science数据库(截止日期2017年2月),检索有关CNB与FNAB比较的文献,2位评价员按照纳入与排除标准独立筛选文献、提取资料和评价纳入文献质量,采用RevMan 5.3软件进行Meta分析。结果:共纳入研究19篇;有关诊断准确性比较文献18篇,其中CNB组2 600例,FNAB组2 777例,Meta分析显示CNB组对比FNAB组诊断准确率差异有统计学意义(RR=1.14,95%CI:1.06~1.22,P<0.01);术后发生血肿情况共纳入文献2篇,其中CNB组3 050例,FNAB组3 497例,二者差异无统计学意义(RR=0.92,95%CI:0.67~1.25,P>0.05)。结论:在熟练掌握穿刺技术情况下,临床中CNB在甲状腺结节诊断中安全可行。

Objective：To evaluate the efficacy and safety of core needle biopsy（CNB）and fine neon needle aspiration biopsy（FNAB）in the diagnosis of thyroid nodules.Method：The CNKI,Wanfang database,China Biomedical Literature Database（CBM）,PubMed,Cochrane Library,EMBASE,Web of Science database（the deadline of February 2017）were used to search the literature on CNB and FNABCNB.Two reviewers independently screened the literature according to the inclusion and exclusion criteria,extracted the data and evaluated the quality of the literature,and used RevMan 5.3software for meta-analysis.Result：The accuracy of the CNB group was higher than that of the FNAB group（RR=1.14,95% CI：1.06-1.22,P〈0.01）.Meta-analysis showed that the accuracy of CNB group compared with FNAB group was statistically significant the difference was statistically significant.There was no significant difference between the two groups（RR=0.92,95% CI：0.67-1.25,P〉0.05）.Conclusion：CNB is safe and feasible in the diagnosis of thyroid nodules under the condition of mastery of puncture technique.