窄带成像内镜对喉癌诊断价值的Meta分析

The value of narrow band imaging endoscopy in the diagnosis of laryngeal cancer: a Meta-analysis

目的评价窄带成像(NBI)内镜对喉癌的诊断价值。方法检索Pubmed、Embase、Web of Science、Cochrane Library、CBM、CNKI及万方数据库,全面收集NBI内镜诊断喉癌及癌前病变的诊断性试验,检索时间截至2018年1月31日。根据纳入和排除标准独立筛选文献,提取资料并按诊断准确性研究的质量评价工具-2(QUADAS-2)评价纳入研究的文献质量,采用Stata 12.0和Review Manager 5.3软件进行Meta分析。结果最终纳入18篇文献,Meta分析结果显示,NBI内镜诊断喉癌的合并敏感度和特异度分别为0.93和0.91,合并阳性似然比(LRP)和阴性似然比(LRN)分别为10.70和0.07;综合诊断比值比(DOR)为149,综合受试者工作特征曲线(SROC)曲线下面积为0.97。似然比点状图显示NBI检查结果阳性可以确诊喉癌,NBI阴性可以排除喉癌的诊断。纳入的18篇文献中有14篇明确报道采用Ni分型进行喉癌诊断,其合并敏感度和特异度分别为0.94和0.91,DOR为147,SROC曲线下面积为0.97。结论 NBI内镜下结合Ni分型能够提高对喉癌诊断的准确性。

Objective To evaluate the role of narrow band imaging(NBI)endoscopy in the diagnosis of laryngeal cancer.Method Systematic literature searches were conducted as of31st January2018in Pubmed,Embase,Web of Science,Cochrane Library,CBM,CNKI,and Wanfang med databases.Literatures were screened as per specific inclusion and exclusion criteria,the updated quality assessment of diagnostic accuracy studies-2(QUADAS-2)was used to assess study quality and potential bias.Meta analysis were performed with Stata12.0and Review Manager5.3software.Result Eighteen studies were included in this Meta-analysis.The pooled sensitivity,specificity,positive likely ratio(LRP),negativelikely ratio(LRN),and diagnostic odds ratio(DOR)for the NBI diagnosis of laryngeal cancer were0.93,0.91,10.70,0.07,and149,respectively,and the area under the curve(AUC)of summary receiver operating characteristics curve(SROC)was0.97.The likelihood ratio Matrix graph indicated that NBI positiveness could confirm the presence of laryngeal cancer while the NBI negativeness would perform well in the exclusion of laryngeal cancer.Among the18studies,14reported using Ni classification,with the pooled sensitivity,specificity,DOR and AUC of SROC being0.94,0.91,147,and0.97,respectively.Conclusion NBI endoscopy combined with Ni classification can improve the diagnostic accuracy of laryngeal cancer.