Yang RenBao, Lu ManPeng, Qian XiaoXing, Chen Jiong, Li Liang, Wang JiaWen, Zhang YouQian
Department of General Surgery, Anhui Medical University Affiliated HeFei Hospital, Hefei Second People's Hospital, Hefei, 230011, China,
J Cancer Res Clin Oncol. 2014 Dec;140(12):2077-86. doi: 10.1007/s00432-014-1728-x. Epub 2014 Jun 11.
The objective of this study was to summarize the accuracy of preoperative vascular invasion with endoscopic ultrasound (EUS) and computed tomography (CT) test performance in pancreatic cancer with meta-analysis
Two reviewers searched MEDLINE database to identify relevant studies. The reference lists of the trials were manually searched. Included studies used surgical and/or histological findings as the "gold standard," and provided sufficient data to construct a diagnostic 2 × 2 table. A statistical program of Meta-Disc was used to calculate the pooled sensitivity, specificity, positive LR, negative LR, DOR, and the SROC curve. Publication bias was assessed by Deeks' asymmetry test. Sensitivity analysis and subgroup analysis were calculated to down the heterogeneity. Meta-regression was calculated to evaluate potential sources of heterogeneity
A total of 30 studies with 1,554 patients were included for the analysis, nine of these studies compared EUS with CT to assess the diagnostic efficiency The pooled sensitivity of EUS and CT was 72 % (95 % CI 67-77 %) and 63 % (95 % CI 58-67 %), and the pooled specificity of EUS and CT was 89 % (95 % CI 86-92 %) and 92 % (95 % CI 90-94 %), respectively. The positive LR of EUS and CT was 5.14 (95 % CI 3.14-8.40) and 6.21 (95 % CI 3.96-9.71), and the negative LR was 0.36 (95 % CI 0.25-0.52) and 0.41 (95 % CI 0.31-0.55), respectively. The AUCs of EUS and CT were 0.9037 and 0.8948. The subgroup analysis of nine studies performed both EUS and CT showed CT scan with a lower sensitivity of 48 % (95 % CI 0.40-0.56), when compared to EUS of 69 % (95 % CI 0.61-0.77). The overall AUCs of CT scan appear to be lower (AUCs = 0.8589), compared with EUS (AUCs = 0.9379) CONCLUSION: EUS performed better than CT in differentiating vascular invasion preoperative on pancreatic cancer. EUS could provide other additional information when compared with CT.
本研究旨在通过荟萃分析总结内镜超声（EUS）和计算机断层扫描（CT）检测胰腺癌术前血管侵犯的准确性。
两名研究者检索MEDLINE数据库以识别相关研究。手动检索试验的参考文献列表。纳入的研究将手术和/或组织学结果用作“金标准”，并提供了足够的数据来构建诊断性2×2列联表。使用Meta-Disc统计程序计算合并敏感度、特异度、阳性似然比、阴性似然比、诊断比值比（DOR）和SROC曲线。通过Deeks不对称检验评估发表偏倚。进行敏感度分析和亚组分析以降低异质性。计算Meta回归以评估异质性的潜在来源。
总共纳入30项研究中的1554例患者进行分析，其中9项研究比较了EUS和CT以评估诊断效率。EUS和CT的合并敏感度分别为72%（95%CI 67-77%）和63%（95%CI 58-67%），EUS和CT的合并特异度分别为89%（95%CI 86-92%）和92%（95%CI 90-94%）。EUS和CT的阳性似然比分别为5.14（95%CI 3.14-8.40）和6.21（95%CI 3.96-9.71），阴性似然比分别为0.36（95%CI 0.25-0.52）和0.41（95%CI 0.31-0.55）。EUS和CT的曲线下面积（AUC）分别为0.9037和0.8948。对9项同时进行EUS和CT检查的研究进行亚组分析显示，与EUS的69%（95%CI 0.61-0.77）相比，CT扫描的敏感度较低，为48%（95%CI 0.40-0.56）。与EUS（AUC=0.9379）相比，CT扫描的总体AUC似乎较低（AUC=0.8589）。
在鉴别胰腺癌术前血管侵犯方面，EUS比CT表现更好。与CT相比，EUS可以提供其他额外信息。
