DWI-ADC值评估乳腺癌新辅助化疗疗效价值的Meta分析

A meta-analysis of DWI-ADC Value for the Evaluation of Neoadjuvant Chemotherapy in Breast Cancer

目的探讨用循证医学Meta分析的方法,评估扩散加权成像(DWI)表观扩散系数(ADC)值用于评价乳腺癌新辅助化疗疗效的准确性。方法通过检索Embase、Pubmed、Cochrane图书馆、其他英文数据库及四大中文数据库中的相关文献,搜集符合纳入标准的原始文献进行质量评价、异质性检验、Meta回归分析及亚组分析,并选择相应的效应合并模型进行Meta分析,汇总敏感度(Se)、特异度(Sp)、阳性似然比(+LR)、阴性似然比(-LR)、诊断比值比(DOR)及汇总受试者工作特征曲线(SROC)。结果共纳入13篇英文文献,汇总DWI-ADC值评估乳腺癌新辅助化疗疗效的Se、Sp、+LR、-LR、DOR及SROC曲线下面积(AUC)分别为0.89(0.85~0.92)、0.71(0.66~0.76)、3.12(2.41~4.04)、0.20(0.13~0.29)、21.34(11.36~40.10)、0.88。结论 DWI-ADC值变化率在早期预测乳腺癌新辅助化疗疗效中具有重要意义。

Objective To evaluate the accuracy and predictive value of DWI-ADC value in the assessment of neoadjuvant chemotherapy in locally advanced breast cancer by Meta-analysis. Methods Relevant studies were retrieved from English and four Chinese databases and assess the quality、data extraction test for heterogeneity、Meta-regression analysis and subgroup analysis,then select the appropriate model combined effect Meta-analysis. The combined Se,Sp,LR,diagnostic odds ratios（DOR）,and AUC of DW-MRI were analysed. Results 13 eligible studies were included. The combined results of DW-MRI of Se,Sp,LR,DOR and AUC was 0. 89（0. 85-0. 92）,0. 71（0. 66-0. 76）,3. 12（2. 41-4. 04）,0. 20（0. 13-0. 29）,21. 34（11. 36-40. 10）,0. 88,respectively. Conclusion The variation of DWI-ADC value can predict the assessment of treatment response of neoadjuvant chemotherapy in locally advanced breast cancer.