内镜窄带成像技术联合放大内镜诊断胃癌准确性的Meta分析

Diagnostic accuracy of magnifying endoscopy with narrow-band imaging in gastric cancer: a Meta-analysis

摘要:

目的 探讨放大内镜联合窄带成像技术（ME-NBI）对胃癌的诊断价值。方法 全面检索Web of Science、Cochrane Library、PubMed、万方数据库、中国知网和维普中文数据库的相关文献，年限为建库至2019年12月，利用Meta-Disc 1.4和Stata 15.0软件进行Meta分析。结果 最终纳入34篇文献，包括7 255例胃癌患者和7 711处病灶。Meta分析结果显示：ME-NBI诊断胃癌准确性的合并灵敏度（SE）为0.87（95%CI：0.85～0.89）；特异度（SP）为0.96（95%CI：0.96～0.97）；约登指数（YI）为0.83；阳性似然比（LR+）为10.91（95%CI：7.16～16.61）；阴性似然比（LR-）为0.15（95%CI：0.11～0.20）；诊断优势比（DOR）为82.61（95%CI：46.64～146.31）；综合受试者工作特征曲线（SROC）下面积（AUC）为0.95（95%CI：0.93～0.97）。结论 ME-NBI对胃癌有较高的诊断价值，为胃癌诊断的重要手段，可指导临床工作。

Abstract:

Objective To explore the diagnostic value of magnifying endoscopy with narrow-band imaging (ME-NBI) in gastric cancer.Methods We searched relevant literatures of Web of Science, Cochrane Library, PubMed, WanFang databases, CNKI and VIP databases comprehensively (up to December 2019). Meta-Disc 1.4 software and Stata 15.0 software were used for meta analysis.Results 34 studies with a total of 7 255 gastric cancer patients and 7 711 lesions were included in the present analysis. Pooled sensitivity of ME-NBI to diagnose gastric cancer is 0.87 (95%CI: 0.85 ~ 0.89); Pooled specificity of ME-NBI to diagnose gastric cancer is 0.96 (95%CI: 0.96 ~ 0.97); Youden index is 0.83; Positive likelihood ratio (LR+) is 10.91 (95%CI: 7.16 ~ 16.61); Negative likelihood ratio (LR-) is 0.15 (95%CI: 0.11 ~ 0.20); Diagnostic Odds Ratio (DOR) is 82.61 (95%CI: 46.64 ~ 146.31); Area under SROC curve (AUC) is 0.95 (95%CI: 0.93 ~ 0.97).Conclusion ME-NBI has a high diagnostic value for gastric cancer, which can be used as an important measure for diagnosis of gastric cancer and guide clinical work.