Shi Fang, Zhang Qian, Liang Zhenzhen, Zhang Mengmeng, Liu Xin
Department of Epidemiology and Statistics, School of Public Health, Jilin University, No. 1163, Xinmin Avenue, Changchun 130021, China.
Br J Cancer. 2017 Oct 10;117(8):1185-1191. doi: 10.1038/bjc.2017.262. Epub 2017 Aug 10.
To estimate the accuracy of one-step nucleic acid amplification (OSNA) assay as an intra-operative sentinel lymph node biopsy (SLNB) for sentinel lymph node (SLN) metastasis in breast cancer.
PubMed, Cochrane Library and Web of Science databases were searched by two independent reviewers to retrieve literature with per-patient analysis. The deadline was up until December 2016. A meta-analysis was performed using STATA, Meta-Disc, and Revman software. A random-effects model was used and subgroup analysis was carried out to identify possible sources of heterogeneity.
According to the inclusion criteria, 2833 patients from 12 studies were included in this meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and the area under the sROC curve (AUC) for detecting SLN metastasis were 0.87 (95% CI 0.81-0.91), 0.92 (95% CI 0.86-0.95), 10.65 (95% CI 6.18-18.34), 0.14 (95% CI 0.10-0.20), 75.08 (95% CI 37.77-149.22) and 0.94 (95% CI 0.91-0.95), respectively.
The present study adds the evidence that OSNA assay is an accurate molecular diagnostic tool for intra-operatively detecting SLN metastasis in breast cancer. One-step nucleic acid amplification assay might be introduced into clinical usage for replacing traditional intro-operative diagnostic methods of SLNB.
评估一步核酸扩增(OSNA)检测作为术中前哨淋巴结活检(SLNB)用于检测乳腺癌前哨淋巴结(SLN)转移的准确性。
由两名独立审阅者检索PubMed、Cochrane图书馆和Web of Science数据库,以获取个体患者分析的文献。截止日期为2016年12月。使用STATA、Meta-Disc和Revman软件进行荟萃分析。采用随机效应模型,并进行亚组分析以确定异质性的可能来源。
根据纳入标准,本荟萃分析纳入了12项研究中的2833例患者。检测SLN转移的合并敏感性、特异性、阳性似然比(PLR)、阴性似然比(NLR)、诊断比值比(DOR)和sROC曲线下面积(AUC)分别为0.87(95%CI 0.81 - 0.91)、0.92(95%CI 0.86 - 0.95)、10.65(95%CI 6.18 - 18.34)、0.14(95%CI 0.10 - 0.20)、75.08(95%CI 37.77 - 149.22)和0.94(95%CI 0.91 - 0.95)。
本研究补充了证据,表明OSNA检测是术中检测乳腺癌SLN转移的一种准确的分子诊断工具。一步核酸扩增检测可能会被引入临床应用以取代传统的术中SLNB诊断方法。