经阴道超声检测子宫内膜癌患者宫颈浸润的诊断性能：一项系统评价和Meta分析

Diagnostic Performance of Transvaginal Ultrasound for Detecting Cervical Invasion In Women With Endometrial Carcinoma: A Systematic Review and Meta-analysis.

作者信息

Alcázar Juan Luis, Pérez Lidia, Güell Olga, Haro Núria, Manzour Nabil, Chacon Enrique, Jurado Matías

机构信息

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

Department of Obstetrics and Gynecology, Hospital Fundación Jimenez-Diaz, Madrid, Spain.

出版信息

J Ultrasound Med. 2019 Jan;38(1):179-189. doi: 10.1002/jum.14682. Epub 2018 May 6.

DOI:10.1002/jum.14682

PMID:29732585

Abstract

OBJECTIVES

To evaluate the role of transvaginal ultrasound (TVUS) for diagnosing cervical invasion in the preoperative assessment of endometrial carcinoma.

METHODS

A search for studies evaluating the role of TVUS for assessing cervical invasion in endometrial carcinoma from January 1990 to December 2016 was performed in the PubMed/MEDLINE, Web of Science, www.ClinicalTrials.gov, and www.who.int/trialsearchdatabases. The quality of the studies was evaluated by the Quality Assessment of Diagnostic Accuracy Studies 2.

RESULTS

We identified 211 citations. Ultimately, 17 studies comprising 1751 women were included. The mean prevalence of cervical invasion was 16.3%. The risk of bias was high in 7 studies for the domains "patient selection" and "index test," whereas it was considered low for the "reference test" domain. Overall, the pooled estimated sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of TVUS for detecting cervical invasion were 63% (95% confidence interval [CI], 51%-74%), 91% (95% CI, 87%-94%), 10.2 (95% CI, 5.7-18.3), and 0.38 (95% CI, 0.28-0.53), respectively. Heterogeneity was high for both sensitivity and specificity.

CONCLUSIONS

Transvaginal ultrasound has acceptable diagnostic performance for detecting cervical invasion in women with endometrial carcinoma.

摘要

目的

评估经阴道超声（TVUS）在子宫内膜癌术前评估中诊断宫颈浸润的作用。

方法

在PubMed/MEDLINE、科学网、www.ClinicalTrials.gov和www.who.int/trialsearchdatabases中检索1990年1月至2016年12月期间评估TVUS在子宫内膜癌宫颈浸润评估中作用的研究。采用诊断准确性研究质量评估2对研究质量进行评估。

结果

我们识别出211篇引文。最终，纳入了17项研究，共1751名女性。宫颈浸润的平均患病率为16.3%。7项研究在“患者选择”和“索引测试”领域的偏倚风险较高，而在“参考测试”领域被认为较低。总体而言，TVUS检测宫颈浸润的合并估计敏感性、特异性、阳性似然比和阴性似然比分别为63%（95%置信区间[CI]，51%-74%）、91%（95%CI，87%-94%）、10.2（95%CI，5.7-18.3）和0.38（95%CI，0.28-0.53）。敏感性和特异性的异质性均较高。