US-FNAB技术联合突变基因检测对甲状腺癌的诊断价值研究:Meta分析  

Diagnostic value of US-FNAB technology combined with mutation gene detection for thyroid cancer: a Meta-analysis

作　　者：陈海燕[1] 李继业[1] 杜少斐 宋丹[1] 左秀玲[1] 王志宏[1] Chen Haiyan;Li Jiye;Du Shaofei;Song Dan;Zuo Xiuling;Wang Zhihong(Department of Endocrinology,Zhengzhou First People’s Hospital,Zhengzhou 450004,China)

机构地区：[1]郑州市第一人民医院内分泌科,郑州450004

出　　处：《中国实用医刊》2022年第22期6-10,共5页Chinese Journal of Practical Medicine

基　　金：2020年河南省医学科技攻关计划联合共建项目 (LHGJ20200696)。

摘　　要：目的探讨超声引导下细针穿刺活检(US-FNAB)技术联合突变基因检测对甲状腺癌的诊断价值。方法检索PubMed、Embase、科学网、Cochrane、中国知网、万方数据库、维普数据库、中国生物医学文献数据库中有关US-FNAB技术联合BRAF、RAS及TERT突变基因检测对甲状腺癌的诊断性研究,检索时间为建库至2022年1月,按照一定标准纳入文献,应用RavMan 5.4按照QUADAS-2标准对文献进行质量评价,使用MetaDisc 1.4软件和Stata 16.0进行Meta分析。结果共纳入5篇文献,其在病例选择、金标准及病例流程进展情况3个方面偏倚风险较小,而在待评价试验方面的偏倚风险较大。Meta分析结果显示,US-FNAB技术联合BRAF、RAS及TERT突变基因检测诊断甲状腺癌的合并敏感度为0.56(95%CI 0.51~0.61),合并特异性为0.91(95%CI 0.88~0.93),合并阳性似然比为6.18(95%CI 3.20~11.95),合并阴性似然比为0.50(95%CI 0.39~0.64),合并诊断比值比为12.67(95%CI 5.33~30.10),曲线下面积为0.6611(Q指数=0.6223)。结论US-FNAB技术联合BRAF、RAS及TERT突变基因检测对甲状腺癌诊断具有较高的特异性,有助于避免过度手术,但还需要更多研究予以证实。Objective To investigate the diagnostic value of ultrasound-guided fine needle aspiration biopsy(US-FNAB)combined with mutation gene detection in thyroid cancer.Methods The studies on US-FNAB combined with BRAF,RAS and TERT gene mutation detection in diagnosis of thyroid cancer were searched from the databases including PubMed,Embase,Web of Science,Cochrane,China National Knowledge Infrastructure,Wanfang Database,VIP Database,and China Biomedical Literature Database.The retrieval time was from the establishment of the database to January 2022,and the literature was included according to certain standards.RavMan 5.4 was used to evaluate the quality of the literature according to the QUADAS-2 standard,and the software MetaDisc 1.4 and Stata 16.0 were used for meta-analysis.Results A total of 5 papers were included,and their risk of bias was small in three aspects,including case selection,gold standard and case process progress,while the risk of bias in the trials to be evaluated was relatively large.Results of Meta-analysis showed that the pooled sensitivity of US-FNAB combined with BRAF,RAS and TERT mutation gene detection in the diagnosis of thyroid cancer was 0.56(95%CI 0.51-0.61),and the pooled specificity was 0.91(95%CI 0.88-0.93),the pooled positive likelihood ratio and the negative likelihood ratio were 6.18(95%CI 3.20-11.95)and 0.50(95%CI 0.39-0.64),respectively.The pooled diagnostic odds ratio was 12.67(95%CI 5.33-30.1),the pooled area under the curve was 0.6611(Q index=0.6223).Conclusions US-FNAB combined with BRAF,RAS and TERT mutation gene detection has a high specificity in the diagnosis of thyroid cancer,and is conductive to avoiding excessive surgery.However,more studies are needed to confirm the result.

关 键 词：甲状腺癌 超声引导 甲状腺细针穿刺 突变基因检测 

分 类 号：R736.1[医药卫生—肿瘤]