超声内镜对胃癌TN分期诊断准确性的Meta分析

目的评估超声内镜(EUS)诊断胃癌TN分期的准确性。方法检索PubMed、Web of Science、CNKI、万方和维普等数据库中的相关研究,检索时间设定为建库至2020年4月,使用Meta-Disc1.4软件进行Meta分析。结果共纳入文献数量为28篇,涉及胃癌患者3 130例。Meta分析结果表明:EUS诊断胃癌TN分期的合并灵敏度(Se):T1期为0.81 (95%CI:0.79～0.84)、T2期为0.68 (95%CI:0.65～0.71)、T3期为0.80 (95%CI:0.78～0.82)、T4期为0.72 (95%CI:0.68～0.77)、N0期为0.81 (95%CI:0.79～0.83)、N1期为0.60 (95%CI:0.57～0.63)、N2期为0.49 (95%CI:0.46～0.52);特异度(Sp):T1期为0.96(95%CI:0.96～0.97)、T2期为0.88 (95%CI:0.87～0.89)、T3期为0.86 (95%CI:0.84～0.87)、T4期为0.97(95%CI:0.94～0.97)、N0期为0.79 (95%CI:0.77～0.80)、N1期为0.77 (95%CI:0.76～0.79)、N2期为0.92(95%CI:0.90～0.93);汇总受试者工作特征曲线(SROC)下面积(AUC):T1期为0.97、T2期为0.89、T3期为0.90、T4期为0.95、N0期为0.90、N1期为0.78、N2期为0.85。结论 EUS在诊断胃癌TN分期中的准确性较高,可以应用于胃癌的术前诊断与分期,为临床提供指导。

Diagnostic accuracy of endoscopic ultrasonography in TN staging for gastric cancer: a Meta-analysis

Objective To assess the accuracy of endoscopic ultrasonography (EUS) in the diagnosis of TN staging of gastric cancer.Methods A detailed search was executed in PubMed, Web of Science, CNKI, WanFang and VIP databases (up to April 2020). A meta analysis was carried out by Meta-Disc 1.4.Results 28 studies involving 3 130 patients with gastric cancer were included. Pooled sensitivity of EUS to diagnose TN staging were T₁ 0.81 (95%CI: 0.79 ~ 0.84), T₂ 0.68 (95%CI: 0.65 ~ 0.71), T₃ 0.80 (95%CI: 0.78 ~ 0.82), T₄ 0.72 (95%CI: 0.68 ~ 0.77), N₀ 0.81 (95%CI: 0.79 ~ 0.83), N₁ 0.60 (95%CI: 0.57 ~ 0.63), N₂ 0.49 (95%CI: 0.46 ~ 0.52); Pooled specificity of EUS to diagnose TN staging were T₁ 0.96 (95%CI: 0.96 ~ 0.97), T₂ 0.88 (0.87 ~ 0.89), T₃ 0.86 (95%CI: 0.84 ~ 0.87), T₄ 0.97 (95%CI: 0.94 ~ 0.97), N₀ 0.79 (95%CI: 0.77 ~ 0.80), N₁ 0.77 (95%CI: 0.76 ~ 0.79), N₂ 0.92 (95%CI: 0.90~0.93); Area under SROC curve (AUC) were T₁ 0.97, T₂ 0.89, T₃ 0.90, T₄ 0.95, N₀ 0.90, N₁ 0.78, N₂ 0.85.Conclusion Endoscopic ultrasonography with high accuracy in the diagnosis of TN staging of gastric cancer can be applied in the preoperative diagnosis and staging of gastric cancer and provide guidance in clinical practice.