对比增强光谱乳腺摄影在乳腺癌筛查中的诊断价值：系统评价和荟萃分析。
Diagnostic Value of Contrast-Enhanced Spectral Mammography for Screening Breast Cancer: Systematic Review and Meta-analysis.
机构信息
Department of Breast Surgery of Affiliated Tumor Hospital of Guangxi Medical University, Guangxi, PR China.
Department of Oncology, Panyu Hospital of Chinese Medicine, Guangdong, PR China.
出版信息
Clin Breast Cancer. 2018 Oct;18(5):e985-e995. doi: 10.1016/j.clbc.2018.06.003. Epub 2018 Jun 15.
BACKGROUND
Contrast-enhanced spectral mammography (CESM) is a new image examination technology that has developed over the past few years. As CESM technology keeps improving, a current meta-analysis review is needed to systematically evaluate the potential diagnostic value of CESM.
METHODS
A total of 18 studies were included in the review. Sensitivity, specificity, and other important parameters of CESM accuracy for breast cancer diagnosis were pooled and analyzed using random-effects models. Summary receiver operating characteristic curves were calculated for overall accuracy estimation.
RESULTS
The summary estimates for CESM in the diagnosis of breast cancer were as follows: the pooled sensitivity and specificity were 0.89 (95% confidence interval [CI], 0.88-0.91) and 0.84 (95% CI, 0.82-0.85), respectively. Positive likelihood ratio was 3.73 (95% CI, 2.68-5.20), negative likelihood ratio was 0.10 (95% CI, 0.06-0.15), and diagnostic odds ratio was 71.36 (95% CI, 36.28-140.39). The area under the curve was 0.96 (standard error = 0.011).
CONCLUSION
CESM has a high diagnostic accuracy for evaluating breast cancer and can be considered as a useful test for initial assessment of breast lesions.
背景
对比增强光谱乳腺成像（CESM）是近年来发展起来的一种新的影像检查技术。随着 CESM 技术的不断进步，需要进行当前的荟萃分析综述，以系统评估 CESM 的潜在诊断价值。
方法
本综述共纳入 18 项研究。使用随机效应模型汇总并分析了 CESM 对乳腺癌诊断的准确性的敏感性、特异性和其他重要参数。计算了综合接收者操作特征曲线以进行总体准确性估计。
结果
CESM 诊断乳腺癌的汇总估计值如下：合并的敏感性和特异性分别为 0.89（95%置信区间 [CI]，0.88-0.91）和 0.84（95%CI，0.82-0.85）。阳性似然比为 3.73（95%CI，2.68-5.20），阴性似然比为 0.10（95%CI，0.06-0.15），诊断优势比为 71.36（95%CI，36.28-140.39）。曲线下面积为 0.96（标准误=0.011）。
结论
CESM 对评估乳腺癌具有较高的诊断准确性，可被视为评估乳腺病变的有用初始检查方法。
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