增强CT对诊断肾脏占位性病变价值的Meta分析

A meta-analysis of evaluation of contrast-enhanced CT for renal spaceoccupying lesions

目的系统评价关于增强CT对诊断肾脏占位性病变的临床价值。方法计算机系统检索PubM ed、Cochrane Library、Embase、中国知网、维普数据库和中国生物医学文献数据库中关于增强CT诊断肾脏占位性病变的相关中英文文献,发表时间在2008年1月～2018年4月。应用Metadisc 1.4及Stata 15.1软件对纳入文献的研究数据进行统计学分析,并利用准确性研究(QUADAS)量表对纳入的文献进行质量评价。结果最终共纳入符合标准文献17篇,共包含1099个肾脏占位性病灶。各研究组间异质性明显,故采用随机效应模型。汇总增强CT诊断肾脏占位性病变的合并敏感度(SEN)、合并特异度(SPE)、诊断比数比(DOR)阳性似然化(+LR)、阴性似然比(-LR)、SROC曲线下面积(AUC)和Q指数分别为0.85(95%CI:0.82～0.87)、0.68(95%CI:0.62～0.74)、11.30(95%CI:6.53～19.55)、2.34 (95%CI:1.84～2.97)、0.24 (95%CI:0.17～0.32)、0.8489、0.7801。结论增强CT对于肾脏占位性病变良恶性诊断具有较好的临床价值。

Objective To systematically review the cIinical value of contrast-enhanced CT (CECT) in diagnosis of renal space-occupying lesions. Methods Literatures concerning contrast-edhanced CT diagnosis of renal space-occupying lesions published from January 2008 to April 2018 were electronically searched in the databases including PubMed, Cochrane Library, Embase, CNKI, VIP and CBM. Statistical analysis were performed via Metadisc 1.4 and Stata 15.1 software, and QUADAS scale was used to evaluate the quality of the enrolled literatures. Results Totally 17 literatures that met the standards were inrolled incIuding 1099 renal space-occupying lesions cases in total. The heterogeneity of the study group was obvious, so the random effect model was adopted. The combined sensitivity (SEN), combined specificity (SPE), diagnostic ratio (DOR), positive likelihood ratio (+LR), negative likelihood ratio (-LR), area under SROC curve (AUC) and Q index of the renal space-occupying lesions diagnosed by CECT were 0.85(95%CI: 0.82-0.87), 0.68(95%CI: 0.62-0.74), 11.30(95%CI: 6.53-19.55), 2.34(95%CI:1.84-2.97), 0.24(95%CI:0.17-0.32), 0.8489, 0.7801. Conciusion CECT is effective in the diagnosis of benign and malignant renal space-occupying lesions.