Bin Lian, Huihui Yang, Weiping Yang, Changyuan Wei, Qinghong Qin, Weiyu Meng
Department of Breast Surgery of Affiliated Tumor Hospital of Guangxi Medical University.
Department of Ultrasound of Hospital of Guangxi Zhuang Autonomous Region.
Ultrasound Q. 2019 Mar;35(1):68-73. doi: 10.1097/RUQ.0000000000000433.
Currently, the aim of differentiating malignant from benign breast tumors and diagnosing early breast cancer is more accurately fulfilled with the addition of ultrasound (US) scans. Some studies have shown that three-dimensional (3D) imaging opens a new diagnostic window because of a better and more detailed impression of the spatial arrangement of focal breast masses. Therefore, we carried out this study to assess the efficacy of 3D-US diagnostic techniques for the detection of breast cancer using systemic analyses. We searched the MEDLINE, Pubmed, EMBASE, and Cochrane Library for using 3D-US for the diagnosis of breast cancer. The terms used were "three-dimensional ultrasound", "breast neoplasms", "sensitivity and specificity", and "accuracy". Patients were adults. The quality of the studies was checked according to Quality Assessment of Diagnostic Accuracy Studies criteria. We calculated the diagnostic accuracy rates and developed a meta-analysis to synthesize the results. Twelve studies of diagnostic tests were selected, which were of moderate to high quality. The pooled sensitivity was 0.923 (95% confidence interval [CI], 0.896-0.945), and the pooled specificity was 0.872 (95% CI, 0.849-0.893). The meta-analysis detected a threshold effect and heterogeneity between studies. The pooled positive likelihood ratio was 6.965 (95% CI, 5.242-9.255), the negative likelihood ratio was 0.106 (95% CI, 0.079-0.142), and the diagnostic odds ratio was 84.239 (95% CI, 52.237-135.84). This meta-analysis indicates that 3D-US has acceptable diagnostic accuracy rates in differentiating malignant from benign breast tumors.
目前，通过增加超声（US）扫描能更准确地实现鉴别乳腺良恶性肿瘤以及诊断早期乳腺癌的目标。一些研究表明，三维（3D）成像由于能更好、更详细地呈现乳腺局灶性肿块的空间排列，从而打开了一个新的诊断窗口。因此，我们开展了本研究，通过系统分析来评估3D-US诊断技术在检测乳腺癌方面的效能。我们在MEDLINE、Pubmed、EMBASE和Cochrane图书馆中检索使用3D-US诊断乳腺癌的相关文献。使用的检索词为“三维超声”“乳腺肿瘤”“敏感性和特异性”以及“准确性”。研究对象为成年人。根据诊断准确性研究的质量评估标准对研究质量进行检查。我们计算了诊断准确率并进行荟萃分析以综合结果。共选取了12项诊断试验研究，质量为中到高。合并敏感性为0.923（95%置信区间[CI]，0.896 - 0.945），合并特异性为0.872（95%CI，0.849 - 0.893）。荟萃分析检测到研究之间存在阈值效应和异质性。合并阳性似然比为6.965（95%CI，5.242 - 9.255），阴性似然比为0.106（95%CI，0.079 - 0.142），诊断比值比为84.239（95%CI，52.237 - 135.84）。该荟萃分析表明，3D-US在鉴别乳腺良恶性肿瘤方面具有可接受的诊断准确率。
