多层螺旋CT用于术前胃癌T分期诊断的Meta分析

Meta-analysis of multi-slice spiral CT in preoperative T staging diagnosis of gastric cancer

目的:使用Meta分析方法评价螺旋CT用于胃癌术前T分期的诊断价值。方法:计算机检索中国知网、万方、维普、PubMed、Web of Science等数据库,检索时间自2006年1月—2020年8月,搜集螺旋CT对胃癌术前T分期的诊断性试验。对文献进行异质性检验和质量评价,合并效应量,绘制受试者工作特征(ROC)曲线并进行综合分析。结果:最终纳入29篇文献,共计2424例研究对象。螺旋CT诊断T1期胃癌的合并灵敏度为0.76(95%CI 0.71~0.81)、特异度为0.96(95%CI 0.95~0.97)、曲线下面积(AUC)为0.93;诊断T2期胃癌的合并灵敏度为0.71(95%CI 0.67~0.75)、特异度为0.91(95%CI 0.90~0.92),AUC为0.90;诊断T3期胃癌的合并灵敏度为0.82(95%CI 0.79~0.84)、特异度为0.86(95%CI 0.84~0.87)、AUC为0.91;诊断T4期胃癌的合并灵敏度为0.85(95%CI 0.82~0.88)、特异度为0.94(95%CI 0.93~0.95)、AUC为0.94。结论:螺旋CT在胃癌术前T分期中与病理分期的一致性较高,可作为胃癌术前分期较好的影像学检查手段。

Objective To evaluate the diagnostic value of multi-slice spiral CT in preoperative T staging of gastric cancer by Metaanalysis.Methods Computer search CNKI,Wanfang,VIP,PubMed,Web of Science,and other databases,searched from January 2006 to August 2020.Diagnostic trials of preoperative T staging of gastric cancer using multi-slice spiral CT were searched,and the heterogeneity test and quality evaluation were performed on the literature.The effect size was combined and the receiver operating characteristic curve was drawn for comprehensive analysis.Results A total of 16 literature was included for the study.The combined sensitivity of spiral CT in the diagnosis of stage T1 gastric cancer was 0.76(95%CI 0.71-0.81),the specificity 0.96(95%CI 0.95-0.97),and AUC 0.93;the combined sensitivity in the diagnosis of stage T2 gastric cancer was 0.71(95%CI 0.67-0.75),specificity 0.91(95%CI 0.90-0.92),and AUC 0.90;the combined sensitivity in the diagnosis of stage T3 gastric cancer was 0.82(95%CI 0.79-0.84),specificity 0.86(95%CI 0.84-0.87),and AUC 0.91;the combined sensitivity in the diagnosis of stage T4 gastric cancer was 0.85(95%CI 0.82-0.88),specificity 0.94(95%CI 0.93-0.95),and AUC 0.94.Conclusion Muti-slice spiral CT demonstrated high consistency in application between preoperative T staging of gastric cancer and pathological staging,and can be used as a proper imageological examination method for preoperative staging of gastric cancer.