超声双重造影用于胃癌术前T分期诊断的Meta分析

Double Contrast-enhanced Ultrasonography in Diagnosis of Preoperative T Staging of Gastric Cancer: A Meta-analysis

目的应用Meta分析方法评价超声双重造影用于胃癌术前T分期的诊断价值。资料与方法计算机检索中国知网、万方、维普、PubMed、Cochrane图书馆、Medline、Embase等数据库,检索时间为2000年1月1日—2018年3月31日。搜集超声双重造影对胃癌术前T分期的诊断性试验。对文献进行异质性检验和质量评价,合并效应量,绘制受试者工作特征曲线并进行综合分析。结果最终纳入8篇文献,共计1508例研究对象。超声双重造影诊断T1期胃癌的合并敏感度为0.80(95%CI 0.74～0.86)、特异度为0.99(95%CI 0.98～0.99)、曲线下面积(AUC)为0.989;诊断T2期胃癌的合并敏感度为0.75(95%CI 0.70～0.79)、特异度为0.91(95%CI 0.89～0.93),AUC为0.815;诊断T3期胃癌的合并敏感度为0.84(95%CI 0.81～0.87)、特异度为0.87(95%CI 0.85～0.89)、AUC为0.940;诊断T4期胃癌的合并敏感度为0.90(95%CI 0.86～0.93)、特异度为0.97(95%CI 0.96～0.98)、AUC为0.971。结论超声双重造影在胃癌术前T分期中与病理分期的一致性较高,可作为胃癌术前分期较好的影像学检查手段。

Purpose To evaluate the diagnostic value of double contrast-enhanced ultrasonography in preoperative T staging of gastric cancer by Meta-analysis. Materials and Methods CNKI, Wanfang, VIP, PubMed, Cochrane Library, Medline, and Embase database were searched via computer, with the search time set from January 1, 2000 to March 31, 2018. Diagnostic trials of preoperative T staging of gastric cancer using double contrast-enhanced ultrasonography was searched, and the heterogeneity test and quality evaluation were performed on the literature. The effect size was combined and the receiver operating characteristic curve was drawn for comprehensive analysis. Results A total of 8 literature (1508 subjects) was included for the study. The combined sensitivity of double contrast-enhanced ultrasonography in the diagnosis of stage T1 gastric cancer was 0.80 (95% CI 0.74-0.86), the specificity 0.99 (95% CI 0.98-0.99), and AUC 0.989;the combined sensitivity in the diagnosis of stage T2 gastric cancer was 0.75 ( 95% CI 0.70-0.79), specificity 0.91 (95% CI 0.89-0.93), and AUC 0.815;the combined sensitivity in the diagnosis of stage T3 gastric cancer was 0.84 (95% CI 0.81-0.87), specificity 0.87 (95% CI 0.85-0.89), and AUC 0.940;the combined sensitivity in the diagnosis of stage T4 gastric cancer was 0.90 (95% CI 0.86- 0.93), specificity 0.97 (95% CI 0.96-0.98), and AUC 0.971. Conclusion Double contrast-enhanced ultrasonography demonstrated high consistency in application between preoperative T staging of gastric cancer and pathological staging, and can be used as a proper imageological examination method for preoperative staging of gastric cancer.