联动成像技术对幽门螺杆菌感染诊断价值的一项Meta分析

Diagnostic efficacy of linked color imaging for Helicobacter pylori infection:a Meta-analysis

目的评估联动成像(linked color imaging,LCI)对幽门螺杆菌(Helicobacter pylori,H.pylori)感染的诊断效能。方法通过计算机检索PubMed、Embase、Cochrane Library、Web of Science、中国知网(CNKI)、万方数据库知识平台(WanFang Data)、维普中文科技期刊(VIP)等7个中英文数据库平台。检索从建库至2021年3月有关LCI对H.pylori感染的诊断性试验研究,并对最终纳入的文献使用诊断性试验证据质量风险评价工具(QUADAS-2)进行文献质量评价。采用随机效应模型评估诊断效能。通过I^(2)统计和χ^(2)检验进行研究的异质性检验,再用敏感性分析来探寻可能的异质性来源。数据分析使用Meta-DiSc(1.4版)软件。结果共纳入7项研究,共计822例患者。LCI诊断H.pylori感染的总敏感度和特异度分别为0.81(95%CI:0.76~0.86)和0.85(95%CI:0.81~0.88),曲线下面积(area under the curve,AUC)为0.9089。在纳入的7项研究中,我们选择了6项研究进行亚组分析来比较LCI和白光成像(white light imaging,WLI)之间的诊断效能,WLI的总敏感度和特异度分别为0.58(95%CI:0.52~0.64)和0.80(95%CI:0.75~0.85),AUC为0.8071。相较之下,在这6项研究中,LCI的总敏感度和特异度分别为0.83(95%CI:0.77~0.87)和0.85(95%CI:0.81~0.89),AUC为0.9176。结论LCI对H.pylori感染具有较高的诊断价值。

Objective To evaluate the diagnostic efficacy of linked color imaging(LCI)for Helicobacter pylori(H.pylori)infection.Methods We searched the PubMed,Embase,Cochrane Library,Web of Science,CNKI,WanFang Data,and VIP databases for relevant published studies.A random effects model was used to assess the diagnostic efficacy.Heterogeneity was tested by the I~2 statistic and Chisquare test.Meta-DiSc(version 1.4)software was used for the data analysis.Sensitivity analysis was performed to analyze the sources of heterogeneity.Results A total of 7 studies including 822 patients were incorporated.The pooled sensitivity and specificity of the selected studies that used LCI for diagnosing H.pylori infection were 0.81(95%CI:0.76-0.86)and 0.85(95%CI:0.81-0.88),respectively,and the area under the curve(AUC)was 0.9089.Among the 7 studies included,6 studies were selected to perform the subgroup analysis for comparing the diagnostic efficacy between LCI and white light imaging(WLI),and the pooled sensitivity and specificity for WLI were 0.58(95%CI:0.52-0.64)and 0.80(95%CI:0.75-0.85),respectively,and the AUC was 0.8071.By contrast,the pooled sensitivity and specificity for LCI were 0.83(95%CI:0.77-0.87)and 0.85(95%CI:0.81-0.89),respectively,and the AUC was 0.9176.Conclusion LCI presents with a relatively high diagnostic value for H.pylori infection.