超声造影评估膀胱肿瘤TNM分期价值的系统评价

Diagnostic performance of contrast-enhanced ultrasound in assessing the TNM staging of bladder tumor:a systematic review and meta-analysis

目的系统评价超声造影(CEUS)在膀胱肿瘤TNM分期中的诊断价值。方法计算机检索PubMed、Cochrane Library、中国知网、维普、万方数据库及中国生物医学文献服务系统,检索时间均从建库至2020年7月,收集包含超声造影评估膀胱肿瘤TNM分期的文献,应用Meta-Disc 1.4软件进行诊断性分析,绘制SROC曲线并计算面积。结果共纳入11篇文献,共计940例患者;Meta分析结果显示,CEUS评估膀胱肿瘤TNM分期的合并敏感性为0.95(0.93~0.98)、合并特异性为0.91(0.87~0.94)、合并阳性似然比为9.02(6.33~12.85)、合并阴性似然比0.05(0.03~0.09)、合并诊断比值比为147.01(73.48~294.12);SROC曲线下面积AUC为0.9854;CEUS的诊断符合率高于CT,差异有统计学意义(P=0.003)。结论CEUS在术前膀胱肿瘤TNM分期的评估中具有较高的敏感性和特异性,值得临床推广应用。

Objective To systematic assess the diagnostic performance of contrast-enhanced ultrasound(CEUS)for evaluating the TNM staging of bladder tumor.Methods The literature on diagnosis trials of CEUS for TNM staging of bladder tumor was searched in electronic databases including PubMed,Cochrane Library,CNKI,VIP,Wanfang data and SinoMed up to July 2020.Meta-Disc 1.4 software was used for meta-analysis and SROC curve.Results A total of 11 trials were included,involving 940 cases.Results of meta-analysis of CEUS for TNM staging of bladder tumor showed that the pooled sensitivity was 0.95(0.93 to 0.98),the pooled specificity was 0.91(0.87 to 0.94),the positive likelihood ratio was 9.02(6.33 to 12.85),the negative likelihood ratio was 0.05(0.03 to 0.09),diagnosis odds ratio was 147.01(73.48 to 294.12),and the AUC of SROC was 0.9854.Accurate diagnosis rate of CEUS was higher than CT(P=0.003).Conclusion CEUS has a higher sensitivity and specificity in the diagnosis of bladder tumor TNM staging.Therefore,CUES should be recommended to use in clinical practice.