Chaparro María, Gisbert Javier P, Del Campo Lourdes, Cantero José, Maté José
Department of Gastroenterology and Hepatology, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Madrid, Spain.
Digestion. 2009;80(1):1-17. doi: 10.1159/000215387. Epub 2009 May 4.
The real accuracy of computed tomographic colonography (CTC) is still unknown.
To perform a meta-analysis of the diagnostic accuracy of CTC for the detection of polyps and colorectal tumors.
Studiesassessing the accuracy of CTC for the detection of colorectal polyps and tumors were selected. data synthesis: Meta-analyses combining sensitivities, specificities and likelihood ratios (LRs) for the diagnosis of polyps and colorectal tumors were carried out.
Forty-seven studies, providing data of 10,546 patients, were included. Overall per-polyp sensitivity of CTC was 66% (64-68%), for polyps 6-9 mm in size it was 59% (56-61%), and 76% (73-79%) for polyps larger than 9 mm. Overall per-patient sensitivity was 69% (66-72%), for polyps 6-9 mm 60% (56-65%), and 83% (70-85%) for lesions larger than 9 mm. Overall CTC specificity was 83% (81-84%). Positive and negative LRs were 2.9 (1.8-4) and 0.38 (0.27-0.53), respectively; for polyps 6-9 mm in size, they were 3.8 (2.5-5.7) and 0.4 (0.27-0.59), and 12.3 (7.7-19.4) and 0.19 (0.12-0.3) for polyps larger than 9 mm.
CTC is highly specific for the detection of colorectal polyps and tumors. Some studies reported high sensitivities, but the results of the studies were highly heterogeneous, while the studied variables explained only part of this discrepancy.
计算机断层结肠成像（CTC）的实际准确性仍不明确。
对CTC检测息肉和结直肠肿瘤的诊断准确性进行荟萃分析。
选择评估CTC检测结直肠息肉和肿瘤准确性的研究。
对诊断息肉和结直肠肿瘤的敏感性、特异性和似然比（LRs）进行荟萃分析。
纳入47项研究，提供了10546例患者的数据。CTC检测息肉的总体敏感性为66%（64%-68%），6-9毫米大小的息肉为59%（56%-61%），大于9毫米的息肉为76%（73%-79%）。每位患者检测息肉的总体敏感性为69%（66%-72%），6-9毫米的息肉为60%（56%-65%），大于9毫米的病变为83%（70%-85%）。CTC总体特异性为83%（81%-84%）。阳性和阴性似然比分别为2.9（1.8-4）和0.38（0.27-0.53）；对于6-9毫米大小的息肉，分别为3.8（2.5-5.7）和0.4（0.27-0.59），对于大于9毫米的息肉，分别为12.3（7.7-19.4）和0.19（0.12-0.3）。
CTC检测结直肠息肉和肿瘤具有高度特异性。一些研究报告了较高的敏感性，但研究结果高度异质性，而所研究的变量仅解释了这种差异的一部分。
