超声弹性成像对乳腺癌腋窝淋巴结转移诊断价值的系统评价  

Diagnostic value of ultrasonographic elastography in the differential diagnosis of axillary lymph nodes in breast cancer: a systematic review

作　　者：张晓光[1] 张雨[2] 张小利 卢学峰[1] 甄艳华[1] 娜迪热.铁列吾汗 

机构地区：[1]郑州大学第二附属医院超声科,郑州450014 [2]新疆医科大学健康管理学院健康体检部,乌鲁木齐830054 [3]河南省商丘市柘城县人民医院手术室,河南商丘476200 [4]新疆医科大学第一附属医院超声医学中心,乌鲁木齐830054

出　　处：《中国循证医学杂志》2017年第8期915-920,共6页Chinese Journal of Evidence-based Medicine

基　　金：国家自然科学基金资助项目(编号:81360592);河南省医学科技攻关计划项目(编号:201503083)

摘　　要：目的系统评价超声弹性成像在乳腺癌腋窝淋巴结转移中的诊断价值。方法计算机检索The Cochrane Library、Pub Med、CNKI、Wan Fang Data、VIP、Meda Link和CBM数据库,搜集超声弹性成像诊断乳腺癌腋窝淋巴结转移的诊断性试验,检索时限均为建库至2016年10月。由2位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Meta Disc 1.4软件进行Meta分析。结果共纳入9个研究,共735枚淋巴结。Meta分析结果显示,超声弹性成像诊断乳腺癌腋窝淋巴结转移的Sen_(合并)、Spe_(合并)、+LR、–LR和DOR_(合并)分别为0.82[95%CI(0.78,0.86)]、0.76[95%CI(0.72,0.81)]、3.32[95%CI(2.57,4.27)]、0.25[95%CI(0.20,0.31)]和14.77[95%CI(10.20,21.38)],SROC曲线下面积AUC为0.874 1。结论超声弹性成像对乳腺癌腋窝淋巴结转移诊断有较高的敏感性和特异性,其可用于乳腺癌腋窝淋巴结转移的鉴别诊断。Objective To systematically review the diagnostic value of the ultrasonographic elastography in the differential diagnosis of axillary lymph nodes in breast cancer. Methods We electronically searched the databases including The Cochrane Library, PubMed, CNKI, WanFang Data, VIP, MedaLink and CBM for studies about diagnostic value of the ultrasonographic elastography in the differential diagnosis of axillary lymph nodes in breast cancer from inception to October 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Then meta-analysis was performed using MetaDisc 1.4 software. Results A total of 9 studies involving 735 lymph nodes were included. The results of meta-analysis showed that, the pooled sensitivity, pooled specificity, pooled positive likelihood ratio, pooled negative likelihood ratio and DOR were 0.82 （95%CI 0.78 to 0.86）, 0.76 （95%CI 0.72 to 0.81）, 3.32 （95%CI 2.57 to 4.27）, 0.25 （95%CI 0.20 to 0.31）, and 14.77 （95%CI 10.20 to 21.38）, respectively. The AUC of the SROC curve was 0.8741. Conclusion Ultrasonographic elastography has high sensitivity and specificity in the differential diagnosis of axillary lymph nodes in breast cancer, which indicates that it can be used to diagnosis axillary lymph nodes in breast cancer.

关 键 词：腋窝淋巴结 乳腺癌 超声弹性成像 诊断性试验 系统评价 META分析 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]