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磁共振成像与计算机断层扫描结肠成像对结直肠癌的诊断价值：一项遵循PRISMA标准的系统评价和荟萃分析

Diagnostic value of magnetic resonance versus computed tomography colonography for colorectal cancer: A PRISMA-compliant systematic review and meta-analysis.

作者信息

Sun Shuangyan, Yang Changliang, Huang Zhicheng, Jiang Wen, Liu Yan, Wu Hongfen, Zhao Jihong

机构信息

Department of Radiology First Division of Oncolog Medical Oncology Translational Research Lab Department of Radiation Oncology, Jilin Cancer Hospital, Changchun, Jilin, China.

出版信息

Medicine (Baltimore). 2018 Jun;97(22):e10883. doi: 10.1097/MD.0000000000010883.

DOI:10.1097/MD.0000000000010883
PMID:29851808
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6393025/
Abstract

BACKGROUND

Advanced colorectal cancers were associated with poor prognosis, and early diagnosis was important for high-risk patients. Colonography is commonly used for diagnosing colorectal cancer. However, a few studies reported the diagnostic value of magnetic resonance colonography (MRC) versus computed tomography colonography (CTC). This study aimed to compare the diagnostic value of MRC versus CTC for colorectal cancer.

METHODS

Twenty-three studies on the diagnosis of colorectal cancer using MRC or CTC were obtained from PubMed, Embase, and the Cochrane Library databases until July 2017. The ratios of sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and receiver operating characteristic (ROC) curve were calculated to compare the diagnostic value of MRC versus CTC.

RESULTS

The summary sensitivity, specificity, PLR, NLR, and area under the ROC for MRC were 0.97 (0.81-1.00), 0.92 (0.80-0.97), 11.71 (4.46-30.73), 0.03 (0.00-0.24), and 0.98 (0.97-0.99), respectively, for diagnosing colorectal cancer. The pooled estimates for CTC in diagnosing colorectal cancer were as follows: sensitivity, 0.96 (0.90-0.98); specificity, 1.00 (0.99-1.00); PLR, 197.32 (73.21-531.85); NLR, 0.04 (0.02-0.11); and area under the ROC, 1.00 (0.99-1.00). No significant differences were found between MRC and CTC for sensitivity, specificity, and NLR. MRC was associated with lower PLR and area under the ROC for diagnosing colorectal cancer compared with CTC.

CONCLUSION

This study demonstrated MRC and CTC as potential diagnostic approaches for colorectal cancer. CTC had a higher diagnostic value of PLR and area under the ROC for colorectal cancer.

摘要

背景

晚期结直肠癌预后较差，对高危患者进行早期诊断很重要。结肠造影常用于诊断结直肠癌。然而，少数研究报告了磁共振结肠造影（MRC）与计算机断层扫描结肠造影（CTC）的诊断价值。本研究旨在比较MRC与CTC对结直肠癌的诊断价值。

方法

截至2017年7月，从PubMed、Embase和Cochrane图书馆数据库中获取了23项关于使用MRC或CTC诊断结直肠癌的研究。计算敏感性、特异性、阳性似然比（PLR）、阴性似然比（NLR）和受试者工作特征（ROC）曲线的比值，以比较MRC与CTC的诊断价值。

结果

MRC诊断结直肠癌的汇总敏感性、特异性、PLR、NLR和ROC曲线下面积分别为0.97（0.81 - 1.00）、0.92（0.80 - 0.97）、11.71（4.46 - 30.73）、0.03（0.00 - 0.24）和0.98（0.97 - 0.99）。CTC诊断结直肠癌的汇总估计值如下：敏感性为0.96（0.90 - 0.98）；特异性为1.00（0.99 - 1.00）；PLR为197.32（73.21 - 531.85）；NLR为0.04（0.02 - 0.11）；ROC曲线下面积为1.00（0.99 - 1.00）。MRC与CTC在敏感性、特异性和NLR方面未发现显著差异。与CTC相比，MRC诊断结直肠癌的PLR和ROC曲线下面积较低。

结论

本研究证明MRC和CTC是结直肠癌的潜在诊断方法。CTC对结直肠癌的PLR和ROC曲线下面积具有更高的诊断价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/256f/6393025/3e41ca351b66/medi-97-e10883-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/256f/6393025/46b98aeb461b/medi-97-e10883-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/256f/6393025/13b138c14e5d/medi-97-e10883-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/256f/6393025/11ba312e0f2a/medi-97-e10883-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/256f/6393025/7412169b9bc8/medi-97-e10883-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/256f/6393025/3e41ca351b66/medi-97-e10883-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/256f/6393025/46b98aeb461b/medi-97-e10883-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/256f/6393025/13b138c14e5d/medi-97-e10883-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/256f/6393025/11ba312e0f2a/medi-97-e10883-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/256f/6393025/7412169b9bc8/medi-97-e10883-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/256f/6393025/3e41ca351b66/medi-97-e10883-g008.jpg

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