超声引导下穿刺活检诊断甲状腺结节良恶性Meta分析

目的采用Meta分析评价超声引导下穿刺组织学活检对甲状腺结节良恶性的诊断价值。方法检索PubMed和中国国家知识基础设施(CNKI)、万方数据库中关于超声引导下穿刺活检诊断甲状腺结节的中、英文文献。应用诊断性试验准确性评价(QUADAS)工具评价文献质量。采用Stata 11.0统计软件进行数据分析,获得相关的敏感度、特异度、阳性似然比、阴性似然比、诊断优势比,绘制汇总受试者工作特性(SROC)曲线,计算曲线下面积(AUC)。结果共纳入文献14篇。合并敏感度、特异度分别为0.96[95%CI(0.93,0.98)]、0.98[95%CI(0.96,0.99)],合并阳性似然比、阴性似然比、诊断优势比分别为47.78[95%CI(26.53,86.05)]、0.04[95%CI(0.02,0.07)]、1 151.12[95%CI(487.95,2 715.62)]。SROC曲线的AUC为0.99[95%CI(0.98,1.00)]。结论超声引导下穿刺活检诊断甲状腺结节良恶性具有较高敏感度和特异度。

Ultrasound-guided histology biopsy in diagnosis of benign and malignant thyroid nodules: Meta analysis

Objective To evaluate the clinical value of ultrasound-guided histology biopsy in diagnosis of benign and malignant thyroid nodules with Meta analysis. Methods A comprehensive search in PubMed, China National Knowledge Infrastructure (CNKI) and Wanfang data was performed to identify relevant English and Chinese studieds about ultrasound-guided histology biopsy in diagnosis of benign and malignant thyroid nodules. The quality of the included studies was assessed using the QUADAS items. The Stata software (version 11.0) was used to merge sensitivity, specificity, positive likelihood radio, negative likelihood radio and diagnostic odds ratio. The summary receiver operating characteristic curve (SROC) was used for calculating the area under the curve (AUC). Results A total of 14 studies were collected. Meta analysis showed that the summary sensitivity and specificity was 0.96 (95% CI[0.93, 0.98]) and 0.98 (95% CI[0.96, 0.99]), respectively. And the summary positive likelihood radio, negative likelihood radio and diagnostic odds ratio was 47.78 (95% CI[26.53, 86.05]), 0.04 (95% CI[0.02, 0.07]) and 1 151.12 (95% CI[487.95,2 715.62]), respectively. The AUC of SROC curve was 0.99 (95% CI[0.98, 1.00]). Conclusion Ultrasound-guided histology biopsy has high sensitivity and specificity for diagnosing benign and malignant thyroid nodules.