Sun Changling, Han Xue, Li Xiaoying, Zhang Yayun, Du Xiaodong
1 Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Jiangnan University, The Fourth People's Hospital of Wuxi City, Wuxi, China.
2 Medical College of Jiangnan University, Wuxi, China.
Otolaryngol Head Neck Surg. 2017 Apr;156(4):589-597. doi: 10.1177/0194599816685701. Epub 2017 Feb 7.
Objective To evaluate the performance of narrow band imaging (NBI) for the diagnosis of laryngeal cancer and to compare the diagnostic value of NBI with that of white light endoscopy. Data Sources PubMed, Embase, Cochrane Library, and CNKI databases. Review Methods Data analyses were performed with Meta-DiSc. The updated Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess study quality and potential bias. Publication bias was assessed with the Deeks's asymmetry test. The protocol used in this article has been published on PROSPERO and is in accordance with the PRISMA checklist. The registry number for this study is CRD42015025866. Results Six studies including 716 lesions were included in this meta-analysis. The pooled sensitivity, specificity, and diagnostic odds ratio for the NBI diagnosis of laryngeal cancer were 0.94 (95% confidence interval [95% CI]: 0.91-0.96), 0.89 (95% CI: 0.85-0.92), and 142.12 (95% CI: 46.42-435.15), respectively, and the area under receiver operating characteristics curve was 0.97. Among the 6 studies, 3 evaluated the diagnostic value of white light endoscopy, with a sensitivity of 0.81 (95% CI: 0.76-0.86), a specificity of 0.92 (95% CI: 0.88-0.95), and a diagnostic odds ratio of 33.82 (95% CI: 14.76-77.49). The evaluation of heterogeneity, calculated per the diagnostic odds ratio, gave an I of 66%. No marked publication bias ( P = .84) was detected in this meta-analysis. Conclusion The sensitivity of NBI is superior to white light endoscopy, and the potential value of NBI needs to be validated in future studies.
目的 评估窄带成像(NBI)在喉癌诊断中的性能,并比较NBI与白光内镜检查的诊断价值。 数据来源 PubMed、Embase、Cochrane图书馆和中国知网数据库。 综述方法 采用Meta-DiSc进行数据分析。 使用更新后的诊断准确性研究质量评估-2工具评估研究质量和潜在偏倚。 采用Deeks不对称检验评估发表偏倚。 本文使用的方案已在PROSPERO上发表,并符合PRISMA清单。 本研究的注册号为CRD42015025866。 结果 本荟萃分析纳入了6项研究,共716个病变。 NBI诊断喉癌的合并敏感性、特异性和诊断比值比分别为0.94(95%置信区间[95%CI]:0.91-0.96)、0.89(95%CI:0.85-0.92)和142.12(95%CI:46.42-435.15),受试者工作特征曲线下面积为0.97。 在这6项研究中,3项评估了白光内镜检查的诊断价值,敏感性为0.81(95%CI:0.76-0.86),特异性为0.92(95%CI:0.88-0.95),诊断比值比为33.82(95%CI:14.76-77.49)。 根据诊断比值比计算的异质性评估显示I为66%。 本荟萃分析未检测到明显的发表偏倚(P = 0.84)。 结论 NBI的敏感性优于白光内镜检查,其潜在价值有待未来研究验证。