蓝激光内镜系统对消化道病变良恶性鉴别诊断的Meta分析*

Blue laser imaging endoscopy system in differential diagnosis of benign and malignant lesions in gastrointestinal tract: a Meta-analysis*

摘要:

通过Meta分析评价蓝激光内镜系统（BLI）对消化道病变良恶性鉴别诊断的价值，为临床工作提供循证医学证据。方法 检索多个主要中英文文献数据库收集相关文献，设立相关标准对文献进行筛选和评估，提取相关分析指标，使用Meta-DiSc 1.4、Review Manager 5.3和Stata 15软件进行统计学分析。结果 纳入7篇文献共包含2 670处病变，计算合并敏感度为91%（95%CI：88%～92%），计算合并特异度为89%（95%CI：88%～91%），计算合并阳性似然比为8.46（95%CI：5.06～14.15），计算合并阴性似然比为0.11（95%CI：0.07～0.18），计算合并诊断比值比为80.53（95%CI：41.51～156.24）。绘制综合受试者工作特征（SROC）曲线，曲线下面积（AUC）为95.88%（95%CI：93.18%～98.58%）。亚组分析一定程度上降低了研究的异质性，回归分析提示，国家可能是产生异质性的来源，敏感性分析提示研究结果较为稳定。结论 BLI对于消化道良恶性病变诊断具有较高的临床价值，临床应用前景广阔，但仍需要更多规范化的研究来提高研究的质量等级，提升临床可信度。

Abstract:

To evaluate the clinical application of blue laser magnifying endoscopy system in the differential diagnosis of benign and malignant lesions in gastrointestinal tract by meta-analysis, and provide medical evidence for clinical work. Methods Several major Chinese and English literature databases were searched to collect relevant literature, relevant standards were set up to screen and evaluate the literature, relevant analysis indicators were extracted, and statistical analysis was performed by using Meta-DiSc 1.4, Review Manager 5.3 and Stata 15 software. Results 2 670 lesions were included in 7 articles. The combined sensitivity was calculated to be 91% (95%CI: 88% ~ 92%), and the combined specificity was 89% (95%CI: 88% ~ 91%). The calculated positive likelihood ratio was 8.46 (95%CI: 5.06 ~ 14.15), and the calculated negative likelihood ratio was 0.11 (95%CI: 0.07 ~ 0.18). The calculated odds ratio was calculated to be 80.53 (95%CI: 41.51 ~ 156.24). A summary receiver operating characteristic (SROC) curve was plotted with an area under curve (AUC) of 95.88% (95%CI: 93.18% ~ 98.58%). Subgroup analysis reduced the heterogeneity of the study to a certain extent. Regression analysis suggested that the country may be a source of heterogeneity, and sensitivity analysis suggested that the results were stable. Conclusion BLI has high clinical value for the diagnosis of benign and malignant lesions in gastrointestinal tract, and has a promising clinical application. However, more standardized research is necessary to improve the quality level of this study and clinical credibility.