超声内镜对食管癌术前分期准确性的Meta分析

A Meta-analysis of the accuracy of endoscopic ultrasonography in preoperative staging of esophageal cancer

目的:探讨超声内镜对食管癌术前分期的诊断价值。方法:检索PubMed、Embase、Cochrane Library,中国知网(CNKI)、中国生物医学文献库(CBM)、万方数据库、维普数据库(VIP)检索国内外关于超声内镜对食管癌术前分期的文献,时间区间为1990年1月—2019年12月,将符合纳入标准的文献采用Mate-Disc 1.4软件进行Meta分析,合并分析灵敏度、特异度、诊断优势比,并绘制合并受试者工作特征曲线及计算曲线下面积。结果:共14篇文献纳入本次Meta分析,分析结果显示:超声内镜对食管癌术前T、N分期具有较高的准确性,具体:T1~T4及N分期的诊断灵敏度分别为0.74、0.67、0.82、0.55及0.76,特异度分别为0.97、0.81、0.80、0.99及0.73,受试者工作特征曲线下面积分别为0.88、0.86、0.88、0.98及0.84,诊断优势比分别为71.44、7.63、17.92、71.75及11.56。结论:超声内镜对食管癌术前T、N分期具有较高的诊断准确性,可以作为术前分期的重要方法,对指导临床选择合理的治疗手段具有重要意义。

Objective To investigate the diagnostic value of endoscopic ultrasonography in preoperative staging of esophageal cancer.Methods Pubmed,Embase,Cochrane Library,CNKI,CBM,Wanfang database and VIP were used to search domestic and foreign studies on endoscopic ultrasonography in preoperative staging of esophageal cancer from January 1990 to December 2019.Literatures meeting the inclusion criteria were adopted mate-DISC 1.4 Meta-analysis was performed by software,and sensitivity,specificity and diagnostic odds ratio were combined.Operating characteristic curves of the combined subjects were drawn and their areas were calculated.Results A total of 14 literatures were included in this Meta-analysis,and the analysis results showed that endoscopic ultrasonography had high accuracy in preoperative T and N staging of esophageal cancer.Details were as follows:The diagnostic sensitivity of T1~T4 and N stages were 0.74,0.67,0.82,0.55 and 0.76,and the specificity was 0.97,0.81,0.80,0.99 and 0.73,respectively.The area under the subject operating characteristic curve was:The diagnostic odds ratios of 0.88,0.86,0.88,0.98 and 0.84 were 71.44,7.63,17.92,71.75 and 11.56,respectively.Conclusion Endoscopic ultrasonography has high diagnostic accuracy in preoperative T and N staging of esophageal cancer,and can be used as an important method for preoperative staging,which is of great significance for guiding clinical selection of reasonable treatment.