磁共振波谱预测乳腺癌新辅助化疗后病理反应价值的Meta分析  

Diagnostic value of magnetic resonance spectroscoopy in evaluating the pathological response to neoadjuvant chemotherapy in patients with breast cancer:a meta-analysis

作　　者：余洁 陈巧一 马进 YU Jie;CHEN Qiao-yi;MA Jin(Department of Radiology,Yongchuan People's Hospital of Chongqing,Chongqing 402160,CHINA;Department of Radiology,Chongqing Traditional Chinese Medicine Hospital,Chongqing 400021,CHINA)

机构地区：[1]重庆市永川区人民医院放射科,重庆402160 [2]重庆市中医院放射科,重庆400021

出　　处：《海南医学》2024年第23期3465-3471,共7页Hainan Medical Journal

基　　金：重庆市自然科学基金(编号:CSTB2024NSCQ-MSX0526)。

摘　　要：目的利用Meta分析评价磁共振波谱(MRS)预测乳腺癌新辅助化疗后(NAC)病理反应的准确性。方法检索自建库至2023年10月在Cochrane Library、PubMed、Embase及中国知网(CNKI)、万方数据库及维普数据库(VIP)发表的关于MRS评价乳腺癌NAC后病理反应准确性的相关文献。使用QUADAS-2条目评价纳入文献质量,应用Stata15.1、Meta-Disc1.4软件进行Meta分析。结果共纳入9篇文献,其中中文文献2篇,英文文献7篇,共计443例患者。Meta分析结果显示,MRS对乳腺癌NAC后病理反应诊断的合并敏感度为0.79(95%CI:0.68~0.87),合并特异度为0.82(95%CI:0.66~0.92),汇总受试者工作特征(SROC)曲线下面积(AUC)为0.86(95%CI:0.83~0.89)。其中纳入的6篇文献MRS预测NAC后达到病理学完全缓解(pCR)的Meta结果显示,合并敏感度为0.76(95%CI:0.62~0.86),合并特异度为0.84(95%CI:0.64~0.94),SROC曲线的AUC为0.84(95%CI:0.81~0.87)。结论MRS是一种预测乳腺癌对NAC病理反应的重要辅助方法,具有较高的敏感性和特异性,可以为临床诊疗提供有效的依据。Objective To evaluate the accuracy of magnetic resonance spectroscopy(MRS)in quantitatively eval-uating the pathological response after neoadjuvant chemotherapy(NAC)in patients with breast cancer.Methods Co-chrane Library,PubMed,Embase,China National Knowledge Infrastructure(CNKI),Wanfang Data,and VIP were searched from inception to October 2023 for studies on the accuracy of MRS in evaluating pathological response after neoadjuvant chemotherapy in patients with breast cancer.The Quality Assessment of Diagnostic Accuracy(QUA-DAS-2)tool was used to assess the methodological quality of the included studies.Publication bias was assessed by Deek's funnel plot.Meta-analysis was performed by using Stata 15.1 and Meta-Disc 1.4 software.Results Nine arti-cles were included(2 in Chinese and 7 in English),including 443 patients.Meta-analysis results showed that the com-bined sensitivity of MRS after neoadjuvant chemotherapy for breast cancer was 0.79(95%CI:0.68-0.87),the combined specificity was 0.82(95%CI:0.66-0.92),and the area under the curve(AUC)was 0.86(95%CI:0.83-0.89).In six of the nine articles,pathological complete response(pCR)after NAC was predicted by MRS.Meta analysis of the six arti-cles showed that the combined sensitivity was 0.76(95%CI:0.62-0.86),the combined specificity was 0.84(95%CI:0.64-0.94),and the AUC was 0.84(95%CI:0.81-0.87).Conclusion MRS is an important auxiliary method to predict the pathological response to NAC for breast cancer,with high sensitivity and specificity,which can provide an effective basis for clinical diagnosis and treatment.

关 键 词：磁共振波谱成像 新辅助化疗 乳腺癌 META分析 

分 类 号：R737.9[医药卫生—肿瘤]