超声内镜对胃十二指肠胰腺神经内分泌瘤定位优势的Meta分析

The advantages of endoscopic ultrasonography on gasteroentero-pancreatic neuroendocrine tumors' preoperative localization: a Meta-analysis

目的系统评价超声内镜(EUS)对胃十二指肠胰腺神经内分泌瘤(gastroentero-pancreatic neuroendocrine tumors,GEP-NETs)的定位优势。方法通过检索Medline、Pub Med、Embase、Science Citation Index、中国知网、万方、维普等相关数据库,按照纳入、排除标准,筛选符合标准的文献,用Stata SE 12.0进行Meta分析。选择行包括EUS的一种以上影像学检查,之后经术后病理或经超声内镜引导下细针穿刺病理(EUS-FNA)证实为GEP-NETs的病人。比较EUS与CT等其他影像学检查在GEP-NETs整体检出率、病灶<2 cm时GEP-NETs检出率、有功能性神经内分泌瘤上检出率上是否存在优势。结果共纳入10篇文献,543例病人,578个病灶。EUS较CT在GEP-NETs的整体检出率上存在优势(OR=4.61,95%CI:2.98,7.13,P=0.000);EUS较CT在小于2 cm的GEP-NETs的检出率上存在明显优势(OR=12.66,95%CI:6.06,26.44,P=0.000);EUS较CT在有功能的神经内分泌瘤的检出率上存在明显优势(OR=5.74,95%CI:2.97,11.09,P=0.000)。结论通过应用精细血流、高清精细放大及弹性成像等功能,EUS对于GEP-NETs,尤其是<2 cm的GEP-NETs或有功能的神经内分泌瘤的定位较以CT为代表的其他传统影像学方法更有优势。

Objective To assess systematically endoscopic ultrasonography＇s （EUS）advantages on preoperative localization of gastroentero-pancreatic neuroendocrine tumors （GEP-NETs）. Methods We collected the medical literatures published domestically and abroad from Medline, PubMed, Erabase, Science Citation Index, CNKI, Wanfang Database, and CQVIP. The eligible literature of studies was screened out according to the inclusion and exclusion criteria, and the reported data were aggregated statistically using StataSE 12. 0 software. The inclusion criteria concern the clinical results of patients which have done imageological examinations consisting of EUS at least and confirmed by post- operative biopsy or ultrasound-guided fine needle aspiration （EUS-FNA）. Type of literatures included case-control study or retrospective study. Results A total of 10 academic literatures were screened out, including 543 patients and 578 lesions. The overall detected rate of EUS was obviously higher than CT （OR = 4. 61, 95% CI： 2. 98, 7. 13, P = 0. 000）. The detected rate of EUS on tumors smaller than 2 cm was obviously higher than CT （OR = 12. 66, 95% CI： 6. 06, 26. 44, P = 0. 000）. The detected rate of EUS on functional neuroendocrine tumors （FTs） was obviously higher than CT （OR = 5.74, 95% CI.. 2. 97, 11.09, P = 0. 000）. Conclusions EUS has more advantages than CT and other traditional imageological examinations on GEP-NETs＇ preoperative localization especially when tumors are smaller than 2 cm or being FTs.