内镜超声对胰腺神经内分泌肿瘤的诊断准确性：系统评价和荟萃分析。
Diagnostic accuracy of endoscopic ultrasound in pancreatic neuroendocrine tumors: a systematic review and meta analysis.
机构信息
Division of Gastroenterology and Hepatology, University of Illinois Peoria Campus, OSF Saint Francis Medical Center, Peoria, IL 61637, USA.
出版信息
World J Gastroenterol. 2013 Jun 21;19(23):3678-84. doi: 10.3748/wjg.v19.i23.3678.
AIM
To detect pancreatic neuroendocrine tumors (PNETs) has been varied. This study is undertaken to evaluate the accuracy of endoscopic ultrasound (EUS) in detecting PNETs.
METHODS
Only EUS studies confirmed by surgery or appropriate follow-up were selected. Articles were searched in Medline, Ovid journals, Medline nonindexed citations, and Cochrane Central Register of Controlled Trials and Database of Systematic Reviews. Pooling was conducted by both fixed and random effects model).
RESULTS
Initial search identified 2610 reference articles, of these 140 relevant articles were selected and reviewed. Data was extracted from 13 studies (n = 456) which met the inclusion criteria. Pooled sensitivity of EUS in detecting a PNETs was 87.2% (95%CI: 82.2-91.2). EUS had a pooled specificity of 98.0% (95%CI: 94.3-99.6). The positive likelihood ratio of EUS was 11.1 (95%CI: 5.34-22.8) and negative likelihood ratio was 0.17 (95%CI: 0.13-0.24). The diagnostic odds ratio, the odds of having anatomic PNETs in positive as compared to negative EUS studies was 94.7 (95%CI: 37.9-236.1). Begg-Mazumdar bias indicator for publication bias gave a Kendall's tau value of 0.31 (P = 0.16), indication no publication bias. The P for χ² heterogeneity for all the pooled accuracy estimates was > 0.10.
CONCLUSION
EUS has excellent sensitivity and specificity to detect PNETs. EUS should be strongly considered for evaluation of PNETs.
目的
胰腺神经内分泌肿瘤（PNETs）的检测方法多种多样。本研究旨在评估内镜超声（EUS）检测 PNETs 的准确性。
方法
仅选择经手术或适当随访证实的 EUS 研究。在 Medline、Ovid 期刊、Medline 未索引引文和 Cochrane 对照试验中心注册库以及系统评价数据库中进行了检索。采用固定效应和随机效应模型进行合并。
结果
最初的搜索确定了 2610 篇参考文献，从中选择了 140 篇相关文章进行了回顾。从符合纳入标准的 13 项研究（n=456）中提取了数据。EUS 检测 PNETs 的敏感性为 87.2%（95%CI：82.2-91.2）。EUS 的特异性为 98.0%（95%CI：94.3-99.6）。EUS 的阳性似然比为 11.1（95%CI：5.34-22.8），阴性似然比为 0.17（95%CI：0.13-0.24）。EUS 阳性与阴性研究中存在解剖学 PNETs 的诊断优势比为 94.7（95%CI：37.9-236.1）。发表偏倚的 Begg-Mazumdar 偏倚指标 Kendall's tau 值为 0.31（P=0.16），表明不存在发表偏倚。所有汇总准确性估计的 χ²异质性检验 P 值均大于 0.10。
结论
EUS 对检测 PNETs 具有良好的敏感性和特异性。EUS 应强烈考虑用于 PNETs 的评估。
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