摘要
目的:评价超声内镜(endoscopic ultrasonography,EUS)-弹性成像鉴别诊断胰腺肿块良恶性的诊断价值.方法:Meta分析.计算机检索2015-05-01之前在Pubmed、Medline、EMBASE、Science Direct、Springer link、CBM、万方、维普以及中国知网数据库公开发表的有关EUS-弹性成像鉴别诊断胰腺实性肿块良恶性价值的文献,根据已定的纳入排除标准筛选文献并提取数据,采用QUADAS量表进行严格的文献质量评价,运用Meta-Disc1.4统计软件进行异质性分析和综合定量合成,计算汇总的灵敏度、特异度、阳性似然比(positive likelihood ratio,+LR)、阴性似然比(negative likelihood ratio,-LR)、准确度及约登指数,并绘制SROC曲线评估诊断效能,最后利用Stata12.0评估发表偏倚.结果:共纳入15篇英文文献,Meta分析表明:E U S-弹性成像定性法鉴别诊断胰腺实性肿块良恶性价值的合并灵敏度为97%(95%CI:9 5%-9 8%),合并特异度为6 3%(9 5%C I:55%-70%),+L R为2.48(95%C I:1.49-4.12),-LR为0.06(95%CI:0.02-0.15),SROC曲线下面积为0.9013;EUS-弹性成像定量法鉴别诊断胰腺实性肿块良恶性价值时的合并灵敏度为96%(95%CI:94%-97%),合并特异度为71%(95%CI:63%-78%),+LR为3.00(95%CI:1.91-4.70),-L R为0.09(95%C I:0.05-0.15),SROC曲线下面积为0.9193.结论:EUS-弹性成像法鉴别诊断胰腺实性肿块良恶性的诊断效能较高,定性法和定量法灵敏度基本一致,其中定量法有更高的特异性,误诊率低,可以作为早期鉴别诊断胰腺实性肿块良恶性的方法之一,值得临床推广.
AIM：To evaluate the value of endoscopic ultrasonography（EUS） elastography in differential diagnosis of benign and malignant solid pancreatic masses.METHODS：The databases including Pubmed,Medline,EMBASE,Science Direct,Springer link,CBM,Wan fang,VIP and CNKI were searched before May 1,2015 to collect the articles reporting the use of EUS-elastography in differential diagnosis of benign and malignant solid pancreatic masses.The retrieved articles were screened and selected according to the inclusion and exclusion criteria.Quality assessment was conducted using the QUADAS scale.Stata 12.0 software was used to evaluate the publication bias,and Meta-Disc1.4 software was used to analyze the heterogeneity of the included articles,calculate the pooled sensitivity,specificity,positive likelihood and negative likelihood,and plot the SROC curve to evaluate the diagnosis value.RESULTS：A total of 15 English articles were included.The summary sensitivity of qualitative EUS elastography in differential diagnosis of benign and malignant solid pancreatic masses was 97%（95%CI：95%-98%）,the summary specificity was 63%（95%CI：55%-70%）,the positive likelihood ratio was 2.48（95%CI：1.49-4.12）,the negative likelihood ratio was 0.06（95%CI：0.02-0.15）,and the area under the SROC curve was0.9013.The summary sensitivity of quantative EUS elastography in differential diagnosis of benign and malignant solid pancreatic masses was 96%（95%CI：94%-97%）,the summary specificity was 71%（95%CI：63%-78%）,the positive likelihood ratio was 3.00（95%CI：1.91-4.70）,the negative likelihood ratio was0.09（95%CI：0.05-0.15）,and the area under the SROC curve was 0.9193.CONCLUSION：Quantative EUS elastography has a higher specificity than qualitative EUS elastography in differential diagnosis of benign and malignant solid pancreatic masses,and both of them have higher diagnostic value.
出处
《世界华人消化杂志》
CAS
2015年第31期5070-5078,共9页
World Chinese Journal of Digestology
关键词
胰腺肿块
超声内镜-弹性成像
鉴别诊断价值
META分析
Pancreatic masses
Endoscopic ultrasonography elastography
Differential diagnosis
Meta-analysis
