超声造影鉴别诊断胰腺良恶性病变的Meta分析

Meta-analysis on the differential diagnosis of benign and malignant pancreatic masses by contrast-enhanced ultrasound

目的应用Meta分析评价超声造影对胰腺良恶性病变的鉴别诊断价值。方法从Cochrone图书馆、Pub Med、Embase、CNKI、万方及维普数据库检索超声造影鉴别诊断胰腺良恶性病变方面的文献,检索时间限定为从数据库建立到2017年8月7日。由两名研究者分别进行文献筛选并提取相关信息。采用QUADAS工具对纳入文献的质量进行评价,采用Meta-Disc 1.4软件进行统计学分析。结果共20项研究(1356例研究对象)纳入。超声造影鉴别诊断胰腺良恶性病变的汇总敏感性为0.88[95%可信区间(0.85~0.90)],汇总特异性为0.73[95%可信区间(0.69~0.77)],汇总阳性似然比为3.25[95%可信区间(2.36~4.48)],汇总阴性似然比为0.18[95%可信区间(0.13~0.25)],汇总诊断比值比为23.88[95%可信区间(12.94~44.09)],汇总曲线下面积为0.8985,汇总Q*指数为0.8297。各研究间存在异质性,未发现产生异质性的来源。结论超声造影对胰腺良恶性病变具有较好的鉴别诊断价值。

Objective Use meta-analysis to explore the differential diagnostic value for benign and malignant pancreatic masses by contrast-enhanced ultrasound.Methods Related data of Cochrone liberary,Pub Med,Embase,CNKI,Wanfang database and VIP database were searched during the time from establishment to 7 August 2017.The two researchers screened the literature and extracted relevant information respectively.The quality of the literature was evaluated by QUADAS tools,and the meta-discc 1.4 software was used for statistical analysis.Results A total of 20 articles（1356 cases）were included in this study.The overall sensitivity,specificity,positive likelihood ratio,negative likelihood ratio and diagnostic odds ratio of contrast-enhanced ultrasound in the diagnosis of benign and malignant pancreatic masses were 0.88[95%CI（0.85～0.90）],0.73[95%CI（0.69～0.77）],3.25[95%CI（2.36～4.48）],0.18[95%CI（0.13～0.25）],23.88[95%CI（12.94～44.09）],respectively.The AUC and Q＊index were 0.8985 and 0.8297,respectively.There was heterogeneity among the studies,and no source of heterogeneity was found.Conlusion Contrast-enhanced ultrasound is a valuable diagnostic method for benign and malignant pancreatic masses.