窄带成像内镜对鼻咽癌诊断价值的Meta分析  

Diagnostic value of narrow band imaging for people with nasopharyngeal carcinoma:A Meta-analysis

作　　者：沈佳[1] 韩雪[2] 杜晓东[1] 孙常领[1] SHEN Jia HAN Xue DU Xiao-dong SUN Chang-ling(Department of Otolaryngology-Head and Neck Surgery ,Fourth Affiliated Hospital of J iangnan University, Wuxi 214000, P. R. China Medical College of Jiangnan University, Wuxi 214062, P. R. China)

机构地区：[1]江南大学附属第四人民医院耳鼻咽喉头颈外科,江苏无锡214000 [2]江南大学无锡医学院,江苏无锡214062

出　　处：《中华肿瘤防治杂志》2016年第23期1579-1584,1591,共7页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的鼻咽癌是头颈部常见恶性肿瘤之一,由于其易于复发和早期转移,因此鼻咽癌的早期诊断是临床工作中亟待解决的问题。内镜检测技术一直是头颈恶性肿瘤的有效检查方法,但传统白光内镜技术难以检测早期粘膜下病变。窄带成像技术（narrow band imaging,NBI）是一种新型内镜显像技术,可以清晰显示早期癌变部位粘膜下的血管形态分布。本研究通过对比评价NBI内镜与传统白光内镜对鼻咽癌的诊断价值,为临床实践提供参考。方法计算机检索PubMed、Cochrane Library、Ovid、Web of Science和中国知网数据库,并手工检索相关期刊,全面收集NBI方法诊断鼻咽癌的诊断性试验,检索时间截止到2016-01-31。由两位研究员根据纳入和排除标准独立筛选文献,提取资料并按诊断性试验准确性质量评价工具（QUADAS-2）评价质量,采用Stata 12.0软件进行Meta分析。结果最终纳入5篇研究,包括804个研究对象。Meta分析结果显示,窄带成像内镜诊断鼻咽癌的合并灵敏度和特异度分别为0.84（95%CI为0.67-0.94）和0.94（95%CI为0.90-0.97）,层次综合受试者工作特征曲线（hierarchical summary receive operating characteristic,HSROC）曲线下面积为0.95（95%CI为0.92-0.96）。普通白光内镜诊断鼻咽癌的灵敏度和特异度分别为0.68（95%CI为0.59-0.76）和0.92（95%CI为0.62-0.99）。结论 NBI相比普通白光内镜诊断鼻咽癌具有更高的诊断价值,可以作为临床诊断的辅助工具。OBJECTIVE Nasopharyngeal cancer（NPC）is one of the most common cancers in head and neck.The early diagnosis is essential as NPC is easy to relapse and transfer.Endoscopic technique has always been the effective method in head and neck;however,the traditional white-light endoscopic is difficult to differentiate precancerous lesions.Narrow band imaging（NBI）is a novel endoscopic imaging technique,and it is considered of great benefit in detecting superficial mucosal lesions.T he aim of our study was to evaluate the diagnostic performance of NBI and traditional whitelight endoscopy in differentiation with NPC.METHODS We searched PubMed,the Cochrane Library,Ovid,Web of Science,and CNKI databases,and also searched relevant journals to collect the trials on nasopharyngeal carcinoma using NBI.The retrieval time was up to January 31 st,2016.Two investigators independently reviewed the literature according to the inclusion and exclusion criteria,extracted the data and evaluated the quality with the quality assessment tool for the updated diagnostic accuracy studies（QUADAS-2）.The Meta-analysis was conducted by Stata 12.0software.The protocol of this article has published on PROSPERO,which was followed by PRISMA checklist.The register number is CRD42015026244.RESULTS A total of five studies that consist of 804 patients were included.The pooled sensitivity of NBI was 0.84（95%CI：0.67-0.94）,the specificity was 0.94（95%CI：0.90-0.97）,and the area under the hierarchical summary receive operating characteristic（HSROC）was 0.95（95%CI：0.92-0.96）.The pooled sensitivity and specificity of traditional white-light endoscopy were 0.68（95%CI：0.59-0.76）and 0.92（95%CI：0.62-0.99）respectively.CONCLUSION The diagnostic value of NBI for diagnosis of nasopharyngeal cancer is superior than that of traditional white-light endoscopy,and it can be used as an optional tool in clinical diagnosis.

关 键 词：窄带成像 鼻咽癌 诊断试验 META分析 

分 类 号：R739.63[医药卫生—肿瘤]