超声内镜对胃癌术前TN分期准确性的Meta分析

目的:系统评价超声内镜(EUS)对胃癌术前TN分期的准确性.方法:计算机检索CBM、CNNKI、万方及维普中文数据库,检索年限均从建库到2011年5月,全面收集国内有关超声内镜对胃癌术前TN分期的相关研究,手工检索相关杂志、会议论文集、学位论文汇编等.根据Cochrane系统评价方法筛选研究并提取数据,采用Meta-Disc 1.4版软件进行Meta分析.结果:17篇文献符合纳入标准入组本系统评价,包括1571例胃癌患者.Meta分析结果显示:EUS对胃癌术前T1-T4期的诊断准确性均较高,其合并敏感度分别为84.0%、78.8%、78.3%和80.4%,合并特异度分别为97.0%、90.5%、88.2%和95.3%;EUS对胃癌N分期的诊断准确性亦较高,合并Se和Sp分别为72.4%和77.5%,但各指标总体准确性均低于T分期.结论:现有证据表明,EUS对胃癌术前TN分期的诊断准确性较高,可作为临床术前诊断胃癌的有效工具,它对指导临床选择合理的手术方式和治疗手段具有重要意义.

Accuracy of endoscopic ultrasound in the preoperative TN staging for gastric caner: A Meta-analysis

Objective:To evaluate the accuracy of endoscopic ultrasound(EUS) in the preoperative TN staging for gastric cancer(GC).Methods: Based on the principles and methods of Cochrane systematic reviews,we searched CBM,CNKI,Wanfang and VIP databases from inception to May 2011.Articles related to the accuracy of EUS in the preoperative TN staging for GC were selected.Related journals were also searched manually.Two reviewers independently searched and extracted data.Data analysis was conducted by Meta-Disc1.4 software.Results: Seventeen studies with a total of 1571 GC cases which met the inclusion criteria were included in this analysis.Pooled sensitivity of EUS to diagnose T1-T4 staging were 84.0%,78.8%,78.3% and 80.4%,respectively.Pooled specificity of EUS to diagnose T1-T4 were 97.0%,90.5%,88.2% and 95.3%,respectively.To diagnose N staging,EUS had a pooled sensitivity of 72.4% and specificity of 77.5%.However,the accuracy of EUS in the preoperative T staging was superior than N staging.Conclusion: EUS has excellent sensitivity and specificity in accurately diagnosing the TN stage of GC.EUS may be an effective tool for clinical preoperative diagnosis in GC,which plays an improtant role in clinical selection of surgical approach and treatment.