MRI定量参数作为食管癌放化疗早期治疗反应预测指标的Meta分析  

Meta Analysis of MRI Quantitative Parameters as Predictive Indicators for Early Treatment Response to Radiotherapy and Chemotherapy in Esophageal Cancer

作　　者：袁芳 李莹莹 倪莉 李小潘 李新瑜[1] YUAN Fang;LI Yingying;NI Li;LI Xiaopan;LI Xinyu(The First Affiliated Hospital,and College Clinical Medicine of Henan University of Science and Technology,Luoyang,China,471003)

机构地区：[1]河南科技大学临床医学院,河南科技大学第一附属医院,中国洛阳471003

出　　处：《食管疾病》2024年第4期260-266,共7页Journal of Esophageal Diseases

基　　金：河南科技大学第一附属医院科技攻关重点项目(ZLKFJJ20230409)。

摘　　要：目的评估MRI定量参数作为食管癌(esophageal cancer,EC)患者对放化疗治疗反应预测因子的作用。方法检索中英文数据库,筛选并纳入符合标准的文献,利用Stata 15.0进行数据分析,并使用双变量混合效应模型进行Meta分析。对合并敏感度、特异度、阳性似然比、阴性似然比及诊断比值比的具体数值进行运算,最后绘制受试者工作特征曲线,并对曲线下面积(area under the curve,AUC)进行计算得出诊断效能大小。结果纳入文献18篇,累计样本量1100例患者,其中治疗有效630例。分析△ADC[表观扩散系数(apparent diffusion coefficient,ADC)值治疗前与治疗中的改变量]鉴别食管癌患者放化疗治疗反应的准确性,Meta分析的结果显示敏感度、特异度、阳性似然比、阴性似然比、诊断比值比和SROC分别为0.79(95%CI:0.68~0.87),0.87(95%CI:0.72~0.95),6.1(95%CI:2.8~13.5),0.24(95%CI:0.16~0.36),25(95%CI:11~60),和0.89(95%CI:0.86~0.91)。结论△ADC可以作为治疗反应的预测指标。△ADC可以作为指导临床决策的工具。Objective To evaluate the role of MRI quantitative parameters as predictors of response to chemoradiotherapy in patients with EC.Methods Chinese and English databases were retrieved,and eligible studies were included.Stata 15.0 was used for data analysis,and Meta-analysis was conducted with bivariate mixed-effects model.The pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio and 95%confidence interval(95%CI)of the effect size were calculated.The receiver operating characteristic curve was drawn.The diagnostic efficiency by evaluating the area under the curve(AUC)was calculated.Results 18 articles were included,with a cumulative sample size of 1100 patients,including 630 cases with treatment response was effective.The accuracy of△ADC(the change of ADC value before and during treatment)in identifying therapeutic response to radiotherapy and chemotherapy in EC patients was evaluated.The sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio and SROC were 0.79(95%CI:0.68~0.87),0.87(95%CI:0.72~0.95),6.1(95%CI:2.8~13.5),0.24(95%CI:0.16~0.36),25(95%CI:11~60),and 0.89(95%CI:0.86~0.91),respectively.Conclusion△ADC can serve as a predictive indicator for therapeutic response and as a tool to guide clinical decision-making.

关 键 词：食管癌 ADC 容量转移常数 META分析 

分 类 号：R735.1[医药卫生—肿瘤]