Zhang Juanjuan, Yu Yanyan, Li Ying, Wei Lunshou
Department of Ultrasound, Huaihe Hospital of Henan University, Kaifeng, China.
Department of Gastroenterology, Huaihe Hospital of Henan University, Kaifeng, China.
Oncotarget. 2017 Aug 7;8(43):75418-75426. doi: 10.18632/oncotarget.20049. eCollection 2017 Sep 26.
This meta-analysis is aimed at determining the diagnostic value of hepatocellular carcinoma (HCC) with contrast-enhanced ultrasound (CEUS).
A comprehensive literature search of Pubmed, Web of Science, and the Cochrane Library was performed to identify published studies. The methodological quality of the included studies was evaluated. Data from eligible studies were used to estimate the pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive and negative likelihood ratio (LR) and summary receiver operating characteristic (SROC) curve. Meta-Disc and STATA softwares were utilized for all statistical analyses.
Fifty-three eligible studies (publication years ranged from 1998 to 2016) were selected according to inclusion criteria. The meta-analysis showed that the pooled sensitivity and specificity of CEUS to detect HCC were 0.85 (95% CI: 0.84-0.86) and 0.91 (95% CI: 0.90-0.92), respectively. The pooled positive and negative LRs were 6.28 (95% CI: 4.49-8.77) and 0.16 (95% CI: 0.12-0.22), respectively. The pooled DOR was 55.01 (95% CI: 35.25-83.47). The area under the SCOR curve was 0.9432. Meta-regression and funnel plot indicated that sample size, type of contrast agents and publication bias might be the major sources of heterogeneity.
CEUS is a valuable diagnostic tool for identifying HCC in clinic with highly sensitive and specific.
本荟萃分析旨在确定超声造影（CEUS）对肝细胞癌（HCC）的诊断价值。
全面检索了PubMed、科学网和考克兰图书馆，以识别已发表的研究。对纳入研究的方法学质量进行了评估。来自符合条件研究的数据用于估计合并敏感度、特异度、诊断比值比（DOR）、阳性和阴性似然比（LR）以及汇总受试者工作特征（SROC）曲线。所有统计分析均使用Meta-Disc和STATA软件。
根据纳入标准，选择了53项符合条件的研究（发表年份从1998年至2016年）。荟萃分析显示，CEUS检测HCC的合并敏感度和特异度分别为0.85（95%CI：0.84 - 0.86）和0.91（95%CI：0.90 - 0.92）。合并阳性和阴性似然比分别为6.28（95%CI：4.49 - 8.77）和0.16（95%CI：0.12 - 0.22）。合并DOR为55.01（95%CI：35.25 - 83.47）。SROC曲线下面积为0.9432。Meta回归和漏斗图表明，样本量、造影剂类型和发表偏倚可能是异质性的主要来源。
CEUS是临床上用于识别HCC的一种有价值的诊断工具，具有高度的敏感性和特异性。
