窄带成像技术与碘染色对早期食管癌及癌前病变的诊断价值的Meta分析

目的 系统评价内镜窄带成像技术(NBI)与碘染色对早期食管癌及癌前病变的诊断价值.方法 计算机检索PubMed、Embase、中国期刊全文数据库(CNKI)、维普中文科技期刊数据库、万方数字化期刊全文数据库,查找关于评价NBI与碘染色对早期食管癌及癌前病变的诊断价值的文献.对纳入文献采用Meta-Disc 1.4软件进行Meta分析,得出NBI及碘染色的汇总灵敏度、特异度及95%CI,并绘制汇总受试者工作特征(SROC)曲线,计算曲线下面积(AUC),从而评价两种方法的诊断价值.结果 共采用13篇文献,包含病例975例.NBI的汇总灵敏度为0.88(95%CI=0.86～0.90),汇总特异度为0.79(95%CI=0.76～0.82).碘染色的汇总灵敏度为0.95(95%CI=0.93～0.97),汇总特异度为0.45(95%CI=0.40～0.49).两者的AUC值分别为0.938 6、0.952 9.比较两者的AUC值,差异无统计学意义(Z=0.519,P>0.05).结论 NBI与碘染色对诊断早期食管癌及癌前病变的准确性相当,两者均具有一定的临床价值.

Meta analysis on diagnosis value of narrow band imaging and iodine staining in early esophageal cancer and precancerous lesions

Objective To systematically evaluate the value of narrow band imaging(NBI)and iodine staining in early diagnosis of esophageal cancer and precancerous lesions.Methods The databases of PubMed,Embase,CNKI,VIP technological journals and Wanfang digital journals were retrieved by computer for searching the literatures on the value of NBI and iodine staining in diagnosing early esophageal cancer and precancerous lesions.The Meta-Disc 1.4 software was used to conduct the meta analysis and calculate the pooled sensitivity,specificity and 95％ confidence interval(95％ CI).Summary receiver operating characteristic(SROC)curve was drawn and the area under curve(AUC)was calculated,thus the diagnostic values of the two methods were evaluated.Results Totally 13 articles were included,including 975 patients.The pooled sensitivity and specificity for NBI were 0.88(95％CI=0.86 to 0.90)and 0.79(95％CI=0.76 to 0.82).The pooled sensitivity and specificity for iodine staining were 0.95(95％CI=0.93 to 0.97)and 0.45(95％CI=0.40 to 0.49).AUC of SROC for the two methods were 0.938 6 and 0.952 9 respectively.There was no statistically difference in the AUC values between the two methods(Z=0.519,P>0.05).Conclusion NBI and iodine staining are both effective ways in the diagnosis of early esophageal cancer and precancerous lesions.And both of them have a certain clinical value.