扩散加权成像评估肝细胞肝癌微血管侵犯价值的Meta分析

Diffusion Weighted Imaging in Evaluating Microvascular Invasion Value of Hepatocellular Carcinoma:A Meta-Analysis

目的采用Meta分析探索扩散加权成像(DWI)评估肝细胞肝癌(HCC)微血管侵犯(MVI)的临床应用价值。方法检索Cochrance library、Pubmed、Embase、Medline、Ovid、中国知网(CNKI)、中国生物医学文献数据库(CBM)、维普网(VIP)及万方数据库自建库以来至2021年9月应用DWI预测HCC MVI中英文文献,对筛选出的文献提取相关信息,再进行Meta分析。结果总纳入文献11篇,研究病灶961个,经敏感性分析剔除1篇后共计10篇。DWI预测HCC MVI汇总敏感度及特异度分别为0.79(95%CI:0.71~0.85)、0.75(95%CI:0.64~0.83);汇总阳性似然比及阴性似然比分别为3.1(95%CI:2.2~4.5)、0.28(95%CI:0.21~0.38);汇总诊断比值比为11(95%CI:7~18),集成ROC法(SROC)曲线下面积(AUC)0.84(95%CI:0.80~0.87)。异质性检验结果提示汇总特异度存在一定的异质性(P=0.00,I~2=81.12%)。经Meta回归分析发现纳入研究中感兴趣的选取为异质性来源(P=0.03)。Deeks检验显示纳入研究不存在发表偏移。结论DWI有助于HCC MVI的预测。

Objective To explore the clinical application value of diffusion-weighted imaging in evaluating microvascular invasion of hepatocellular carcinoma by Meta-analysis.Methods Search the Cochrance library,Pubmed,Embase,Medline,Ovid,CNKI,CBM,VIP and Wanfang database from the establishment of the database to September 2021.Application of diffusion weighted imaging to predict microvascular invasion of hepatocellular carcinoma in Chinese and English,extract the selected literature Related information,and then meta-analysis.Results A total of 11 articles were included,961 lesions were studied,and a total of 10 articles were eliminated after sensitivity analysis.The aggregate sensitivity and specificity of diffusion-weighted imaging to predict microvascular invasion of hepatocellular carcinoma were 0.79(95%CI:0.71-0.85)and 0.75(95%CI:0.64-0.83),positive likelihood ratio and negative likelihood ratio were 3.1(95%CI:2.2-4.5),0.28(95%CI:0.21-0.38);diagnostic odds ratio was 11(95%CI:7-18),and the area under the SROC curve(AUC)was 0.84(95%CI:0.80-0.87).The results of the heterogeneity test suggested that there was a certain degree of heterogeneity in the summary specificity(P=0.00,I2=81.12%).Meta-regression analysis found that the selection of interest in the included studies was the source of heterogeneity(P=0.03).Deeks test showed that there was no publication bias in the included studies.Conclusion Diffusion-weighted imaging can help predict microvascular invasion of hepatocellular carcinoma.