超声造影诊断乳腺癌前哨淋巴结的META分析

The Value of Contrast-enhanced Ultrasound in Diagnosis of Sentinel Lymph Node in Breast Cancer: A Meta-analysis

目的系统评价超声造影检查对乳腺癌前哨淋巴结的诊断价值。方法通过检索Pub Med、Embase、MEDLINE、CNKI和万方数据库,检索时间为建库至2018. 03,搜集国内外公开发表的超声造影检查用于诊断乳腺癌前哨淋巴结的临床研究,提取相关文献的研究数据,并根据Cochrane协作网推荐的方法对所选文献进行质量评价,采用Meta Di Sc 1. 4软件进行统计分析。结果最终共纳入11篇文献。Meta分析结果显示:合并敏感性为0. 78(95%CI:0. 73～0. 82),合并特异性为0. 87(95%CI:0. 84～0. 89),合并诊断比值比为18. 07(95%CI:11. 95～27. 33),合并阳性和阴性似然比分别为4. 29(95%CI:3. 55～5. 19)、0. 31 (95%CI:0. 25～0. 37),AUC为0. 90,Q指数为0. 83。结论超声造影检查在乳腺癌前哨淋巴结的诊断中具有较高的临床诊断价值。

Objective To evaluate the clinical value of contrast-enhanced ultrasound in the diagnosis of sentinel lymph nodes in breast cancer.Methods The databases including PubMed,Embase,MEDLINE,and CNKI,Wan Fang were searched from their foundation to Mar.2018.Clinical studies about applying sentinel ultrasound to diagnosis of sentinel lymph node in breast cancer from home and abroad were collected and extracted.The literatures were evaluated according to the methods recommended by the Cochrane,and statistical analyses were conducted by using Meta DiSc 1.4.Results A total of 11 articles were included.The meta-analysis indicated that the pooled sensitivity is 0.78 (95%CI:0.73~0.82);the pooled specificity is 0.87 (95%CI:0.84~0.89);and the pooled ratio of diagnosis is 18.07 (95%CI:11.95~ 27.33);the pooled positive and negative likelihood ratios are 4.29 (95%CI:3.55 to 5.19) and 0.31 (95%CI:0.25 to 0.37) respectively;the AUC is 0.90 and the Q index is 0.83.Conclusion Contrast-enhanced ultrasound has a high clinical diagnostic value in the diagnosis of sentinel lymph node in breast cancer.