经阴道超声与磁共振成像用于子宫内膜癌患者肌层浸润术前评估的系统评价和Meta分析

Transvaginal ultrasound versus magnetic resonance imaging for preoperative assessment of myometrial infiltration in patients with endometrial cancer: a systematic review and meta-analysis.

作者信息

Alcázar Juan Luis, Gastón Begoña, Navarro Beatriz, Salas Rocío, Aranda Juana, Guerriero Stefano

机构信息

Department of Obstetrics and Gynecology, Clínica Universidad de Navarra, School of Medicine, University of Navarra, Pamplona, Spain.

Department of Obstetrics and Gynecology, Complejo Hospitalario de Navarra, Pamplona, Spain.

出版信息

J Gynecol Oncol. 2017 Nov;28(6):e86. doi: 10.3802/jgo.2017.28.e86.

OBJECTIVE

To compare the diagnostic accuracy of transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) for detecting myometrial infiltration (MI) in endometrial carcinoma.

METHODS

An extensive search of papers comparing TVS and MRI in assessing MI in endometrial cancer was performed in MEDLINE (PubMed), Web of Science, and Cochrane Database from January 1989 to January 2017. Quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool.

RESULTS

Our extended search identified 747 citations but after exclusions we finally included in the meta-analysis 8 articles. The risk of bias for most studies was low for most 4 domains assessed in QUADAS-2. Overall, pooled estimated sensitivity and specificity for diagnosing deep MI were 75% (95% confidence interval [CI]=67%-82%) and 82% (95% CI=75%-93%) for TVS, and 83% (95% CI=76%-89%) and 82% (95% CI=72%-89%) for MRI, respectively. No statistical differences were found when comparing both methods (p=0.314). Heterogeneity was low for sensitivity and high for specificity for TVS and MRI.

CONCLUSION

MRI showed a better sensitivity than TVS for detecting deep MI in women with endometrial cancer. However, the difference observed was not statistically significant.

目的

比较经阴道超声（TVS）和磁共振成像（MRI）在检测子宫内膜癌肌层浸润（MI）方面的诊断准确性。

方法

对1989年1月至2017年1月期间MEDLINE（PubMed）、科学网和考克兰数据库中比较TVS和MRI评估子宫内膜癌MI的论文进行广泛检索。使用诊断准确性研究质量评估-2（QUADAS-2）工具评估质量。

结果

我们的扩展检索共识别出747条引文，但在排除后，最终纳入荟萃分析的有8篇文章。在QUADAS-2评估的4个主要领域中，大多数研究的偏倚风险较低。总体而言，TVS诊断深部MI的合并估计敏感性和特异性分别为75%（95%置信区间[CI]=67%-82%）和82%（95%CI=75%-93%），MRI分别为83%（95%CI=76%-89%）和82%（95%CI=72%-89%）。两种方法比较时未发现统计学差异（p=0.314）。TVS和MRI的敏感性异质性较低，特异性异质性较高。