传统二维超声和自动乳腺全容积扫查对乳腺良恶性肿块诊断价值的Meta分析

目的系统评价传统二维超声(HHUS)和自动乳腺全容积扫查(ABVS)在乳腺良恶性肿块中的诊断价值。方法计算机检索PubMed、The Cochrane Library、EMbase、Web of Science、Biosis Preview、WanFang Data、VIP、SinoMed和CNKI数据库,搜集有关HHUS和ABVS诊断乳腺肿块的研究,检索时限均为建库至2019年5月31日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Meta-Disc软件进行Meta分析。结果共纳入24个研究。HHUS的合并敏感度(SEN)、特异度(SPE)、诊断比值比(DOR)、阳性似然比(PLR)和阴性似然比(NLR)分别为0.83[95%CI(0.82,0.85)]、0.81[95%CI(0.79,0.82)]、19.71[95%CI(14.93,26.01)]、4.05[95%CI(3.49,4.69)]、0.22[95%CI(0.18,0.26)];ABVS的SEN、SPE、DOR、PLR和NLR分别为0.90[95%CI(0.89,0.92)]、0.88[95%CI(0.87,0.89)]、76.86[95%CI(55.13,107.17)]、7.40[95%CI(6.07,9.04)]、0.11[95%CI(0.09,0.14)]。HHUS和ABVS的工作特征曲线(SROC)下面积(AUC)分别为0.88和0.96。结论当前证据显示,与HHUS相比,ABVS在乳腺肿块的鉴别诊断方面具有更高的临床价值。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。

Diagnostic value of HHUS versus ABVS for benign and malignant breast lesions: a meta-analysis

Objectives To systematically review the diagnostic value of automatic breast volume scanner(ABVS)and handheld ultrasound(HHUS)for benign and malignant breast lesions.Methods PubMed,EMbase,Web of Science,Biosis Preview,The Cochrane Library,WanFang Data,CNKI,VIP and SinoMed databases were electronically searched to collect studies on HHUS versus ABVS for benign and malignant breast lesions from inception to May 31st,2019.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies.Meta-analysis was then performed using Meta-Disc software.Results A total of 24 studies were included.The pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio and diagnostic odds ratio for HHUS were 0.83(95%CI 0.82 to 0.85),0.81(95%CI 0.79 to 0.82),19.71(95%CI 14.93 to 26.01),4.05(95%CI 3.49 to 4.69)and 0.22(95%CI 0.18 to 0.26),and that for ABVS were 0.90(95%CI 0.89 to 0.92),0.88(95%CI 0.87 to 0.89),76.86(95%CI 55.13 to 107.17),7.40(95%CI 6.07 to 9.04),and 0.11(95%CI 0.09 to 0.14),respectively.The areas under the summary receiver operating characteristic curves in the differentiation of benign and malignant breast lesions were 0.88 and 0.96 for ABVS and HHUS,respectively.Conclusions The current evidence shows that ABVS has higher value than HHUS in the diagnosis of benign and malignant breast tumor.Due to limited quality and quantity of the included studies,more high quality studies are required to verify the above conclusion.