细针穿刺活检联合BRAF^(V600E)基因突变检测对甲状腺结节诊断价值的Meta分析  

Diagnostic value of fine needle aspiration combined with BRAF^(V600E) gene mutation detection for thyroid nodules:A Meta-analysis

作　　者：吕亚庆 张蕾 刘承开 王晓东[2] LV Yaqing;ZHANG Lei;LIU Chengkai;WANG Xiaodong(The First Clinical Medi?cal College of Guangzhou University of Chinese Medicine,GuangZhou 510405,China;不详)

机构地区：[1]广州中医药大学第一临床医学院,广州510405 [2]广州中医药大学第一附属医院超声科,广州510405

出　　处：《实用医学杂志》2020年第7期917-924,共8页The Journal of Practical Medicine

基　　金：广东省科技计划项目(编号:2017ZC0148);广州中医药大学单位青年科研人才培优项目(编号:2016QN01);广州中医药大学单位青年科研人才培优项目(编号:2017QN01)。

摘　　要：目的应用Meta分析方法评价细针穿刺活检(fine-needle aspiration,FNA)联合丝/苏氨酸特异性激酶基因V600E(BRAFV600E)突变检测对甲状腺结节的诊断价值。方法截至2019年9月,检索Pub Med、Embase、Web of Science、Cochrane Library、CNKI、VIP、CBM、Wan Fang数据库中有关FNA联合BARFV600E基因突变检测诊断甲状腺结节的文献。按照制定的纳入和排除标准,由2位研究人员独立进行文献筛选及数据提取,应用QUAUDS-2诊断工具对纳入的文献进行偏倚风险评价,采用Stata12.0及Meta-Di Sc1.4软件进行Meta分析。结果共纳入27项研究,包含5249个病灶,Meta分析结果显示,FNA联合BARFV600E基因突变检测诊断甲状结节良恶性的合并敏感度、特异度、阳性似然比、阴性似然比、诊断比值比分别为:0.89[95%CI(0.88~0.90)]、0.95[95%CI(0.94~0.96)]、12.74[95%CI(7.35~22.07)]、0.12[95%CI(0.09~0.16)]、121.15[95%CI(64.08~229.05)],SROC曲线下面积AUC为0.9681(Q指数为0.9167)。Deek漏斗图无明显发表偏倚(P=0.20)。结论FNA联合BARFV600E基因突变检测对甲状腺结节的诊断价值较高。Objective To evaluate the diagnostic value of fine needle aspiration combined with BRAFV600E gene mutation detection for thyroid nodules by meta-analysis.Methods A detail literature search on Pub Med,Embase,Web of Science,Cochrane Library,CNKI,VIP,CBM and Wan Fang database was carried out to evaluatethe diagnosis of thyroid nodules by using fine needle aspiration and BRAFV600E gene mutation detection until Septem-ber 2019.Two independent reviewers performed literature screening and data extraction according to the inclusionand exclusion criteria,and assesed the risk of bias in the included literature by using the Quality Assessment ofDiagnostic Accuracy Studies-2 tool.Then,Meta analysis was performed using Stata 12.0 and Meta-Di Sc 1.4 software.Results A total of 27 studies were included,involving 5249 lesions.The pooled sensitivity,specificity,positivelikelihood ratio,negative likelihood ratio,and diagnostic odds ratio for FNA combined BRAFV600E were 0.89[95%CI(0.88~0.90)]、0.95[95%CI(0.94~0.96)]、12.74[95%CI(7.35~22.07)]、0.12[95%CI(0.09~0.16)]、121.15[95%CI(64.08~229.05)],respectively,and the area under the SROC curve AUC is 0.9681(Q index is 0.9167).There was no significant publication bias in the Deek funnel plot(P=0.20).Conclusion FNA combined with BARFV600E gene mutation detection has high diagnostic performance for thyroid nodules.

关 键 词：细针穿刺活检 BRAF^(V600E)基因突变检测 甲状腺结节 诊断 META分析 

分 类 号：R730.4[医药卫生—肿瘤]