经阴道超声检查对宫颈癌诊断价值的Meta分析

Diagnostic value of transvaginal ultrasonography in cervical cancer:a Meta analysis

目的应用Meta分析系统评价经阴道超声诊断女性宫颈癌的临床价值。方法计算机检索CNKI、VIP、万方、PubMed、WebofScience等数据库,搜索经阴道超声诊断宫颈癌的相关文献,检索时间为数据库建库至2018年6月31月。由两名研究者根据制定的纳入和排除标准对文献进行筛选、提取,使用QUADAS工具评价纳入文献的质量;采用Meta-DiSc 1.4软件对敏感性、特异性、阳性似然比、阴性似然比、诊断比值比进行异质性检验和数据合并分析;绘制汇总受试者工作特征(SROC)曲线并计算曲线下面积和Q^*指数。结果最终纳入25篇文献,共计2333例研究对象。经阴道超声诊断女性宫颈癌的合并敏感性、特异性、阳性似然比、阴性似然比、诊断比值比分别为0.90[95%可信区间(CI):0.88~0.91]、0.95(95%CI:0.93~0.96)、10.88(95%CI:5.47~21.63)、0.13(95%CI:0.09~0.18)、105.99(95%CI:44.07~254.89);SROC曲线下面积为0.9590;Q^*指数为0.9031。结论经阴道超声对宫颈癌有较高的临床诊断价值。

Objective To systematically analyze the clinical value of transvaginal ultrasonography in diagnosis of female cervical cancer by a Meta analysis system.Methods Literature retrieval from CNKI,VIP,WangFang,PubMed,Web of Science and other database to collect the relevant literature on the diagnosis of cervical cancer by transvaginal ultrasonography.The retrieval time was from the establishment to June 31,2018.The literatures were screened and extracted by two researchers according to the rules of the inclusion and exclusion,and the quality of included literature was evaluated by QUADAS tool.The Meta-Disc 1.4 software was used to conduct pooling on sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio.The summary receiver operating characteristic(SROC)curve was plotted and the area under the curve was calculated.Results A total of 25 literatures with totally 2333 patients were included.The pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio of transvaginal ultrasound in the diagnoisis of cervical cancer were 0.90(95%CI:0.88~0.91),0.95(95%CI:0.93~0.96),10.88(95%CI:5.47~21.63),0.13(95%CI:0.09~0.18),105.99(95%CI:44.07~254.89),respectively.The area under the SROC curve was 0.9590,and Q*index was 0.9031.Conclusion Transvaginal ultrasonography has a high value in the clinical diagnosis of cervical cancer.