超声检查对膀胱癌的诊断价值Meta分析

目的 系统评价超声检查对膀胱癌的诊断价值.方法 对PubMed、Cochrone图书馆、中国知网数据库、维普中文科技期刊数据库和万方数据库进行检索,检索时限从建库到2016年5月21日.根据预先制定的纳入和排除标准对文章进行筛选并提取相关数据资料.采用QUADAS工具对纳入文章的质量进行评价,采用Meta-Disc 1.4软件对其敏感性、特异度、阳性似然比、阴性似然比、诊断比值比进行异质性检验和合并分析,并绘制受试者工作特征曲线, 计算曲线下面积(AUC).结果 共有14项研究,2 498例研究对象纳入Meta分析中.各研究间存在异质性,采用随机效应模型对结果进行分析.超声检查诊断膀胱癌的敏感性、特异度、阳性似然比、阴性似然比、诊断比值比分别为0.77 [95% CI(0.73, 0.80)]、0.96 [95% CI(0.95, 0.97)]、9.81 [95% CI(4.31, 22.33)]、0.27 [95% CI(0.21, 0.36)]、52.24 [95% CI(24.59, 110.96)].AUC为0.93,Q*指数为0.86.纳入文献的阈值效应不是产生异质性的主要来源.结论 超声检查诊断膀胱癌具有较低的敏感性和较高的特异度,可以作为膀胱癌的辅助检查手段.

The diagnostic value of ultrasound for bladder cancer: a meta-analysis

Objective To systematically review the diagnostic value of ultrasound for bladder cancer.Methods By searching PubMed, Cochrone liberary, CNKI, VIP database and Wanfang database from establishment to 21 May 2016.All of the eligible articles which conformed to the inclusion and exclusion criteria were harvested, and the methodological quality of each literature was evaluated by QUADAS tools.The Meta-Disc 1.4 software was used to conduct pooling on sensitivity, specificity, positive likelihood radio, negative likelihood ratio and diagnostic odds ratio.Heterogeneity test was performed and the summary receiver operating characteristic curve was drawn for area under the curve (AUC).Results A total of 14 articles, 2 498 cases were analyzed in this study.Significant heterogeneity was found between studies, and random effect model was employed.The pooled sensitivity, specificity, positive likelihood radio, negative likelihood ratio and diagnostic odds ratio of ultrasound for bladder cancer were 0.77 [95% CI(0.73, 0.80)], 0.96 [95% CI(0.95, 0.97)], 9.81 [95% CI(4.31, 22.33)], 0.27 [95% CI(0.21, 0.36)], 52.24 [95% CI(24.59, 110.96)], respectively.The AUC and Q* were 0.93 and 0.86.The threshold effect was not the main source of heterogeneity.Conclusions Ultrasound has a relatively low pooled sensitivity and a relatively high pooled specificity in diagnosing bladder cancer.Thus, ultrasound can be used as auxiliary examination for bladder cancer.