经阴道实时超声弹性成像诊断宫颈癌:Meta分析

Diagnostic value of transvaginal real-time ultrasound elastography for cervical cancer:Meta-analysis

目的采用Meta分析评价经阴道实时超声弹性成像技术诊断宫颈癌的价值。方法检索PubMed、Embase、中国知网、万方及维普数据库,按照纳入及排除标准筛选文献,并提取四格表数据。采用STATA 12.0软件检验异质性并进行统计学分析,选择相应效应模型,合并其效应量(敏感度、特异度),绘制综合ROC曲线,并计算AUC。结果最终纳入25篇文献,包含2 303例患者。经阴道实时超声弹性成像诊断宫颈癌汇总敏感度、特异度、阳性似然比、阴性似然比及诊断比值比分别为0.85[95%CI(0.82,0.88)]、0.88[95%CI(0.83,0.92)]、7.40[95%CI(4.80,11.30)]、0.17[95%CI(0.13,0.21)]和44[95%CI(24,82)],AUC为0.92[95%CI(0.89,0.94)]。回归分析显示异质性来源可能与弹性评分截断值有关。结论经阴道实时超声弹性成像技术对宫颈癌有较高的诊断价值。

Objective To investigate the value of transvaginal real-time elastography in the diagnosis of cervical cancer with Meta-analysis.Methods A systematic search was conducted in PubMed,Embase,CNKI,Wanfang and VIP databases.The literatures were screened according to inclusion and exclusion criteria,and four tabular data were extracted.With Meta Disc version STATA 12.0 software,statistical analysis was performed,and heterogeneity of the included articles was tested.Based on the results of heterogeneity test,proper effect model was selected to calculate the pooled sensitivity and specificity.Summary ROC curve was obtained,and AUC was calculated.Results A total of 25 literatures were enrolled,including 2 303 patients.The pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio and diagnostic odds ratio for transvaginal real-time elastography in the diagnosis of cervical cancer was 0.85(95%CI[0.82,0.88]),0.88(95%CI[0.83,0.92]),7.40(95%CI[4.80,11.30]),0.17(95%CI[0.13,0.21])and 44(95%CI[24,82]),while AUC was 0.92(95%CI[0.89,0.94]),respectively.Regression analysis revealed that the heterogeneity might result from the elastic score cutoff.Conclusion Transvaginal real-time elastography has good diagnostic value in diagnosis of cervical cancer.