痰细胞学液基薄层检测技术对肺癌诊断价值的Meta分析  

Diagnostic value of liquid-based sputum cytology test in lung cancer:a Meta-analysis

作　　者：周丹菲[1] 杨拴盈[1] 蒋梅花[1] 李维[1] 刘晓丽[1] 戎彪学[1] 张薇[1] 

机构地区：[1]西安交通大学医学院第二附属医院呼吸科,西安710004

出　　处：《中华肺部疾病杂志（电子版）》2011年第2期76-80,共5页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：国家自然科学基金(30570795)

摘　　要：目的应用Meta分析法综合评价痰细胞学液基薄层检测技术对支气管肺癌的诊断价值。方法检索PubMed、Cochrane、ISI Web of Knowledge等数据库,检索时间为1990年1月至2011年2月发表的相关文献,收集关于痰细胞学液基薄层检测技术诊断支气管肺癌的相关研究文献并进行信息统计、科学性评估及质量分级;采用Meta-Disc1.4软件固定效应模型进行数据分析;通过汇总敏感度、特异度、汇总似然比及汇总受试者工作特征曲线(SROC曲线)等统计指标综合评价痰细胞学液基薄层检测技术对支气管肺癌的诊断价值。结果共纳入8篇文献,其中英文2篇,中文6篇,样本量为2584例,其中经组织病理学确诊或明确临床诊断的支气管肺癌共1719例,865例非肺部恶性肿瘤患者为对照。异质性检验显示纳入研究齐性好,通过固定模型的汇总计算得出汇总灵敏度为0.44(95%CI0.42,0.46),汇总特异度为1.00(95%CI0.99,1.00),汇总阳性似然比为72.54(95%CI31.66,166.17),汇总阴性似然比为0.50(95%CI0.47,0.53),SROC曲线下面积为0.9736。结论汇总相关研究结果表明:痰细胞学液基薄层检测技术在支气管肺癌的诊断中特异度达到0.99～1.00,但灵敏度仅为0.44,尚不适用于支气管肺癌的筛查。但是本研究纳入文献有限,需要更多高质量、大样本、多中心的研究加以验证。Objective To evaluate the diagnostic value of liquid-based sputum cytology test in carcinoma of the bronchus with Meta-analysis. Methods We searched PubMed ,Cochrane ISI Web of Knowledge and other databases （1990/1-2011/2） to collect studies which evaluated the diagnostic value of liquid-based sputum cytology test in carcinoma of the bronchus. The statistical information and quality of science were assessed and classified. The data were analyzed using Meta- Discl. 4 software. The diagnostic value of liquid-based sputum cytology in carcinoma of the bron- chus was evaluated by the pooled sensitivity, specificity, the likelihood ratio （LR） and summary receiver operating characteristic curve （SROC curve ） statistical indicators. Results Eight literatures were collected including 2 in English and 6 in Chinese, and 2584 subjects were included in the review （1719 carcinoma of the bronchus patients, all diagnosed by pathologic diagnosis or definite clinical diagnosis）. Heterogeneity test showed that the homogeneity of the study was good. By using fixed effects models to analyze the data, the value of the weighted sensitivity was 0.44（95% CI 0.42,0.46）. the soecificitv was 1.00 （95% CI 0.99.1.00） . the nositive likelihood ratio was2.54 （95 % CI 31.66,166.17 ）, negative likelihood ratio was 0.50 （ 95 % CI 0.47,0.53 ）, and the SROC area under the curve （AUC） was 0.9736. Conclusion The current evidence suggested that the specificity and sensitivity of liquid-based sputum cytology test was 1.00 and 0.44 respectively, thus it was still not suitable for carcinoma of the bronchus screening. Since the literatures collected were not so extensive, more high quality lager sized, prospective studies are required to assess its clinical value more accurately.

关 键 词：支气管肺癌 痰细胞学 液基薄层 诊断 META分析 

分 类 号：R562[医药卫生—呼吸系统]