胰腺腺癌诊断中的成像模态：敏感性、特异性及诊断准确性的系统评价与荟萃分析
Imaging modalities in the diagnosis of pancreatic adenocarcinoma: A systematic review and meta-analysis of sensitivity, specificity and diagnostic accuracy.
作者信息
Toft James, Hadden William J, Laurence Jerome M, Lam Vincent, Yuen Lawrence, Janssen Anna, Pleass Henry
机构信息
Nepean Clinical School, University of Sydney, Australia.
Northern Clinical School, University of Sydney, Australia.
出版信息
Eur J Radiol. 2017 Jul;92:17-23. doi: 10.1016/j.ejrad.2017.04.009. Epub 2017 Apr 24.
BACKGROUND
Pancreatic cancer, primarily pancreatic ductal adenocarcinoma (PDAC), accounts for 2.4% of cancer diagnoses and 5.8% of cancer death annually. Early diagnoses can improve 5-year survival in PDAC. The aim of this systematic review was to determine the sensitivity, specificity and diagnostic accuracy values for MRI, CT, PET&PET/CT, EUS and transabdominal ultrasound (TAUS) in the diagnosis of PDAC.
METHODS
A systematic review was undertaken to identify studies reporting sensitivity, specificity and/or diagnostic accuracy for the diagnosis of PDAC with MRI, CT, PET, EUS or TAUS. Proportional meta-analysis was performed for each modality.
RESULTS
A total of 5399 patients, 3567 with PDAC, from 52 studies were included. The sensitivity, specificity and diagnostic accuracy were 93% (95% CI=88-96), 89% (95% CI=82-94) and 90% (95% CI=86-94) for MRI; 90% (95% CI=87-93), 87% (95% CI=79-93) and 89% (95% CI=85-93) for CT; 89% (95% CI=85-93), 70% (95% CI=54-84) and 84% (95% CI=79-89) for PET; 91% (95% CI=87-94), 86% (95% CI=81-91) and 89% (95% CI=87-92) for EUS; and 88% (95% CI=86-90), 94% (95% CI=87-98) and 91% (95% C=87-93) for TAUS.
CONCLUSION
This review concludes all modalities, except for PET, are equivalent within 95% confidence intervals for the diagnosis of PDAC.
背景
胰腺癌，主要是胰腺导管腺癌（PDAC），每年占癌症诊断病例的2.4%，癌症死亡病例的5.8%。早期诊断可提高PDAC患者的5年生存率。本系统评价的目的是确定MRI、CT、PET&PET/CT、EUS和经腹超声（TAUS）在诊断PDAC时的灵敏度、特异度和诊断准确性值。
方法
进行一项系统评价，以识别报告MRI、CT、PET、EUS或TAUS诊断PDAC的灵敏度、特异度和/或诊断准确性的研究。对每种检查方法进行了成比例Meta分析。
结果
共纳入来自52项研究的5399例患者，其中3567例为PDAC患者。MRI的灵敏度、特异度和诊断准确性分别为93%（95%CI=88-96）、89%（95%CI=82-94）和90%（95%CI=86-94）；CT分别为90%（95%CI=87-93）、87%（95%CI=79-93）和89%（95%CI=85-93）；PET分别为89%（95%CI=85-93）、70%（95%CI=54-84）和84%（95%CI=79-89）；EUS分别为91%（95%CI=87-94）、86%（95%CI=81-91）和89%（95%CI=87-92）；TAUS分别为88%（95%CI=86-90）、94%（95%CI=87-98）和91%（95%CI=87-93）。
结论
本评价得出结论，除PET外，所有检查方法在诊断PDAC时在95%置信区间内等效。
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