Wang Yuee, Fan Qingqi, Wang Ting, Wen Jia, Wang Hong, Zhang Tiansong
Department of Infectious Diseases, Jing'an District Central Hospital Shanghai 200040, China.
Department of Gastroenterology, Jing'an District Central Hospital Shanghai 200040, China.
Int J Clin Exp Med. 2015 Oct 15;8(10):17654-63. eCollection 2015.
to evaluate the performance and accuracy of Controlled attenuation parameter CAP for hepatic steatosis detection.
PubMed, EBSCO, Elsevier Science, Ovid, and Wiley were selected to search studies until August 31, 2014. Quality Assessment of Diagnostic Accuracy Studies checklist was used to assess the quality of included studies. Heterogeneity was evaluated using Q test. Sensitivity, specificity, diagnostic odds ratio (DOR), and the area under curve (AUC) with its 95% confidence intervals (CIs) were calculated to evaluate the accuracy of CAP for assessment of hepatic steatosis stage (≥ S1, ≥ S2 and ≥ S3).
Totally 11 studies (13 cohorts) with high methodological qualities were identified. The summary point estimations with 95% CIs of sensitivity, specificity, AUC and DORs were 0.78 (0.71, 0.84), 0.79 (0.70, 0.86), 0.86 (0.82, 0.88), and 14 (7, 27) for ≥ S1; 0.82 (0.74, 0.88), 0.79 (0.73, 0.85), 0.88 (0.85, 0.90) and 18 (10, 30) for ≥ S2; 0.86 (0.82, 0.89), 0.89 (0.86, 0.92), 0.94 (0.91, 0.96) and 51 (35, 76) for ≥ S3. Significant heterogeneity was found among the studies in ≥ S1 and ≥ S3. Threshold effect was existed in ≥ S3, but not in ≥ S1 and ≥ S2. Publication bias was not existed in ≥ S1 and ≥ S2 except ≥ S3.
CAP provides good sensitivity and specificity for detection of ≥ S1, ≥ S2, and ≥ S3 steatosis. However, future studies with large samples are still necessary to confirm the clinical application.
评估受控衰减参数（CAP）检测肝脂肪变性的性能和准确性。
选取PubMed、EBSCO、爱思唯尔科学、Ovid和威利数据库检索截至2014年8月31日的研究。采用诊断准确性研究质量评估清单评估纳入研究的质量。使用Q检验评估异质性。计算敏感性、特异性、诊断比值比（DOR）和曲线下面积（AUC）及其95%置信区间（CI），以评估CAP评估肝脂肪变性分期（≥S1、≥S2和≥S3）的准确性。
共纳入11项方法学质量高的研究（13个队列）。≥S1时，敏感性、特异性、AUC和DOR的95%CI汇总点估计值分别为0.78（0.71，0.84）、0.79（0.70，0.86）、0.86（0.82，0.88）和14（7，27）；≥S2时，分别为0.82（0.74，0.88）、0.79（0.73，0.85）、0.88（0.85，0.90）和18（10，30）；≥S3时，分别为0.86（0.82，0.89）、0.89（0.86，0.92）、0.94（0.91，0.96）和51（35，76）。≥S1和≥S3的研究间存在显著异质性。≥S3存在阈值效应，而≥S1和≥S2不存在。≥S1和≥S2除≥S3外不存在发表偏倚。
CAP对检测≥S1、≥S2和≥S3脂肪变性具有良好的敏感性和特异性。然而，仍需未来大样本研究来证实其临床应用。
