小探头超声内镜诊断早期胃癌浸润深度准确性的Meta分析

Diagnostic accuracy of miniprobe endoscopic ultrasonography in assessment of tumor invasion depth in early gastric cancer: a Meta-analysis

目的对小探头超声内镜诊断早期胃癌浸润深度的准确性进行定量系统评价。方法检索PubMed、Cochrane Library、Embase、CNKI、万方、维普数据库检索相关文献。对纳入的文献用Stata 14.2软件进行meta分析,得出汇总敏感度、特异度、阳性似然比、阴性似然比、诊断优势比及其95%CI,绘制总受试者工作特征曲线(SROC),并计算曲线下面积(AUC)等,评估其诊断价值。结果共纳入文献16篇,包括3 168例病灶,汇总敏感度、特异度、阳性似然比、阴性似然比、诊断优势比及其95%CI分别是0.85(95%CI:0.78~0.90),0.73(95%CI:0.65~0.80),3.2(95%CI:2.4~4.1),0.20(95%CI:0.14~0.30),16(95%CI:9~26),SROC曲线下面积为0.85。结论小探头超声内镜虽不能准确诊断早期胃癌M/SM1层浸润,但仍能很大程度提高对早期胃癌浸润深度的正确判断。

Objective To evaluate the diagnostic accuracy of miniprobe endoscopic ultrasonography（ EUS） in assessment of tumor invasion depth in early gastric cancer. Methods We searched on the Pub Med,Cochrane Library,Embase,CNKI,Wan Fang data,VIP data for relevant studies published. Stata 14. 2 software was used to perform the Meta-analysis for sensitivity,specificity,positive likelihood ratio（ LR）,and negative LR,diagnostic odds ratio and 95% CI. A summary receiver-operating characteristic（ SROC） curve was constructed,the area under the curve（ AUC） was calculated,and the diagnostic value was evaluated.Furthermore,to explore the potential sources of heterogeneity,we used meta-regression to estimate the effect of the characteristics of the studies on the diagnostic accuracy of miniprobe EUS,and a subgroup analysis was performed. We assessed the publication bias using Deeks＇ Funnel plot. Results Sixteen studies with a total of 3 168 tumors were included in the analysis. The pooled sensitivity,specificity,positive likelihood ratio（ LR）,negative LR,diagnostic odds ratio and 95% CI and area under curve（ AUC） were 0. 85（ 95% CI： 0. 78-0. 90）,0. 73（ 95% CI： 0. 65-0. 80）,3. 2（ 95% CI： 2. 4-4. 1）,0. 20（ 95% CI： 0. 14-0. 30）,16（ 95% CI： 9-26）. The AUC of SROC curve was 0. 85. No significant publication bias was found with Deeks＇ Funnel plot.Conclusion Miniprobe EUS can not accurately diagnose or exclude the M/SM1 layer invasion in early gastric cancer,but it still can greatly improve the diagnostic accuracy of invasion depth in early gastric cancer.