超声造影对乳腺癌诊断价值的Meta分析  

Value of contrast-enhanced ultrasound in diagnosis of breast cancer:A Meta-analysis

作　　者：刘俊平[1] 钱超文[2] 陈俊英[2] 陈丽羽[2] 

机构地区：[1]浙江大学医学院,浙江杭州310031 [2]浙江省肿瘤医院超声科,浙江杭州310022

出　　处：《中国医学影像技术》2010年第12期2309-2312,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的采用Meta分析评价超声造影对乳腺癌的临床诊断价值。方法检索Cochrane图书馆、PubMed和中国国家知识基础设施(CNKI)文献库中的文献,根据Cochrane协作网筛选与诊断试验方法组推荐的诊断试验纳入标准筛选文献,对文献进行质量评价,并提取纳入研究的特征信息。采用Stata11.0统计软件检验异质性,根据双变量随机效应模型,获得敏感度和特异度均值及其95%可信区间,计算曲线下面积,最后进行敏感性和漏斗图分析。结果共纳入13篇英文文献,研究对象共计745例。纳入研究存在异质性,汇总的敏感度和特异度均值及其95%可信区间为0.89(0.82～0.94)和0.79(0.69～0.87),SROC曲线下面积为0.92(0.89～0.94)。纳入文献稳定性较好,Deeks漏斗图分析提示未见明显发表偏倚(P=0.67)。结论 Meta分析提示,超声造影诊断乳腺癌具有较高的敏感度,但特异度中等,还需要高质量的前瞻性研究以更准确地评价其临床价值。Objective To observe the diagnostic value of contrast-enhanced ultrasound （CEUS） in patients with primary breast cancers with a Meta-analysis. Methods A comprehensive search in Cochrane Library,PubMed,and China National Knowledge Infrastructure （CNKI） was performed to identify relevant English and Chinese articles from Jan 1995 to Dec 2009,respectively. According to the criteria for diagnostic research published by the Cochrane Methods Group on Screening and Diagnostic Tests,subsequently,the characteristics of the included articles were appraised and extracted. Statistical analysis was performed with software Stata 11.0 vision. The heterogeneity of the included articles was tested. According to the bivariate random effects model,the mean sensitivity and specificity were calculated. Summary receive operating characteristic （SROC） curve was performed and then the under curve （AUC） was calculated. Finally,the analysis of sensitivity was performed and publication bias was analyzed with certain funnel plot. Results Thirteen of 287 retrieved articles were included,with a total of 745 patients. The included studies had heterogeneity. The mean sensitivity and specificity for CEUS and 95% confidence interval （95%CI） was 0.89 （0.82—0.94） and 0.79 （0.69—0.87）,respectively. The AUC of SROC was 0.92 （0.89—0.94）. Sensitivity analysis demonstrated no disproportionate influences of individual studies. Deeks funnel plot suggested the publication bias was not significant （P=0.67）. Conclusion Meta-analysis indicates that CEUS is a valuable diagnostic method which has higher sensitivity but medium specificity in detecting breast cancer. Howerver,more supports from high-quality prospective researches are desired.

关 键 词：乳腺肿瘤 超声检查 造影剂 META分析 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]