磁共振成像在宫颈癌分期中诊断准确性的系统评价再评价  

An overview of systematic reviews of the diagnostic accuracy of magnetic resonance imaging in the staging of cervical cancer

作　　者：张玫[1] 李腾飞 田金徽[2] 郑卿勇 许建国 崔雅婷 ZHANG Mei;LI Tengfei;TIAN Jinhui;ZHENG Qingyong;XU Jianguo;CUI Yating(Department of Radiology,Gansu Cancer Hospital,Lanzhou 730050,China;Centre for Evidence-Based Medicine,School of Basic Medical Sciences,Lanzhou University,Lanzhou 730000,China;School of Nursing,Gansu University of Traditional Chinese Medicine,Lanzhou 730000,China)

机构地区：[1]甘肃省肿瘤医院放射科,甘肃兰州730050 [2]兰州大学基础医学院,循证医学中心,甘肃兰州730000 [3]甘肃中医药大学护理学院,甘肃兰州730000

出　　处：《兰州大学学报(医学版)》2025年第2期37-48,共12页Journal of Lanzhou University(Medical Sciences)

基　　金：甘肃省卫生行业科研计划项目(GSWSKY2017-38)。

摘　　要：目的系统评价磁共振成像在宫颈癌分期诊断中的准确性,并分析相关系统评价/Meta分析的方法学质量、报告质量和证据质量,旨在评估磁共振成像的诊断价值,并为临床合理应用磁共振成像提供科学依据。方法通过检索中国知网、万方数据知识服务平台、中国生物医学文献数据库、PubMed、Embase、Web of Science和Cochrane Library数据库,收集截至2024年5月20日的关于磁共振成像在宫颈癌分期诊断准确性的系统评价/Meta分析。文献筛选和数据提取由两名研究人员独立完成,并采用ROBIS工具、PRISMA报告规范和GRADE系统分别评估纳入文献的方法学质量、报告质量和证据质量。结果共纳入20篇系统评价/Meta分析,其方法学质量、报告质量和证据质量分级普遍较低。正电子发射断层成像/计算机断层扫描和弥散加权成像在宫颈癌淋巴结转移的诊断上表现优于磁共振成像,磁共振成像在宫旁浸润、膀胱侵犯、直肠侵犯以及子宫内口侵犯方面显示出较高的诊断准确性。结论磁共振成像在宫颈癌分期诊断中显示出较高的价值,但目前纳入的文献在方法学质量、报告质量和证据质量等级方面有待提高。因此,未来需要进行更多高质量的系统评价/Meta分析,以进一步验证磁共振成像的诊断效果。Objective To systematically evaluate the accuracy of magnetic resonance imaging(MRI)in the staging diagnosis of cervical cancer,and analyse the methodological quality,reporting quality and evidence quality of the related systematic reviews/Meta-analyses,aiming at assessing the diagnostic value of MRI and providing a scientific basis for the rational application of MRI in clinical practice.Methods We searched the China National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,Chinese Biomedical Literature Database,Pubmed,Embase,Web of Science and Cochrane Library databases,and collected systematic reviews/Meta-analyses up to May 20,2024 on the diagnostic accuracy of MRI in cervical cancer staging.Two researchers independently completed literature screening and data extraction.We assessed the methodological quality,reporting quality and evidence quality of the included literature using the ROBIS tool,PRISMA reporting specifications and the GRADE system.Results A total of 20 systematic evaluations/Meta-analyses were included with a generally low methodological quality,quality of reporting,and quality of evidence grading.Positron emission tomography/computed tomography and diffusion-weighted imaging outperformed MRI in the diagnosis of lymph node metastasis in cervical cancer,while MRI showed high diagnostic accuracy in paracervical infiltration,bladder invasion,rectal invasion,and endometrial invasion.Conclusion MRI shows high value in the diagnosis of the staging of cervical cancer,but the currently included literature needs improvement in terms of methodological,reporting quality and quality level of evidence.Therefore,more high-quality systematic reviews/Meta-analyses are needed in the future to further validate the diagnostic efficacy of MRI.

关 键 词：磁共振成像 宫颈癌分期 诊断 敏感度 特异度 系统评价再评价 

分 类 号：R737.33[医药卫生—肿瘤]