非增强MRI及扩散加权成像对成人前列腺癌诊断价值的Meta分析

Diagnostic Value of Non-enhanced MRI and Diffusion Weighted Imaging in Adult Prostate Cancer:a Meta analysis

目的:评价非增强MRI及扩散加权成像(DWI)对成人前列腺癌的诊断价值。方法:搜索2007年1月至2017年1月国内外公开发表的以手术病理或活检为诊断金标准的,关于非增强MRI及DWI诊断成人前列腺癌的文献,按照筛选标准选取符合条件的文献,并提取以上合格研究的相关信息。运用Stata14.0软件进行异质性检验,采用Meta Disc1.4软件通过匹配效应模型计算出合并敏感度和特异度,绘制森林图和漏斗图,并采用受试者工作特征曲线(SROC)评估此方法的准确性。结果:共纳入合格文献16篇,Meta分析结果显示,非增强MRI及DWI对成人前列腺癌的诊断均有较高的准确度,汇总其敏感度为59%(95%CI:57%~61%),特异度为89%(95%CI:88%~90%),SROC分析结果表明其曲线下面积为0.879。结论:目前关于非增强MRI及DWI诊断成人前列腺癌是一种准确性较高、无创的检查方法。

Objective:To evaluate the overall diagnostic value of non-enhanced MRI and DWI in adults with Prostate cancer.Methods:All the papers concerning the diagnosis of prostate cancer using non-enhanced MRI and DWI in both English and Chinese published had been searched and reviewed,and the studies with the surgery or pathology as the gold standard were adopted as eligible.According to the requirements of Meta analysis and the recognized quality standard of diagnostic test,we assessed whether all the included studies were eligible and extracted the characteristic information of the above studies.Stata14.0 software was used to test the heterogeneity of the above features.After that,MetaDisc1.4 software was used to calculate the total sensitivity and specificity.The diagnostic accuracy of the method was evaluated by Meta,and the receiver operating characteristic curve(SROC)was used to evaluate the accuracy of the method.Results:16 articles were in accordance with the inclusion criteria.The pooled indexes of diagnostic performance and summary receiver operating characteristic curve(SROC)demonstrated a high discriminatory power for detection prostate cancer by non-enhanced MRI and DWI.In the pooled estimates,sensitivity and specificity were 59%(95%confidence interval 0.57 to 0.61)and 89%(95%confidence interval 0.88 to 0.90)respectively,AUC was 0.879.Conclusion:Non-enhanced MRI and DWI may be a highly accurate and non-invasion diagnostic tool for detecting prostate cancer in dults.