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一步核酸扩增检测子宫内膜癌淋巴结转移的准确性

Accuracy of One-Step Nucleic Acid Amplification in Detecting Lymph Node Metastases in Endometrial Cancer.

作者信息

Raffone Antonio, Travaglino Antonio, Santoro Angela, Esposito Italia, Angelico Giuseppe, Spadola Saveria, Zannoni Gian Franco

机构信息

Gynecology and Obstetrics Unit, Department of Neurosciences, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy.

Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.

出版信息

Pathol Oncol Res. 2020 Oct;26(4):2049-2056. doi: 10.1007/s12253-019-00727-9. Epub 2019 Aug 23.

Abstract

One-step nucleic acid amplification (OSNA) is used to intraoperatively detect sentinel lymph node metastases in breast cancer. OSNA has also been proposed in endometrial cancer, but evidence in this regard is unclear to define the diagnostic accuracy of OSNA in detecting lymph node metastases in endometrial cancer. A systematic review and meta-analysis was performed by searching 8 electronic databases from their inception to March 2019 for studies testing the diagnostic accuracy of OSNA in detecting sentinel lymph node metastasis in endometrial cancer. Pathologic ultrastaging was the reference standard. Sensitivity, specificity, positive and negative likelihood ratio (LR+ and LR-), diagnostic odds ratio (DOR) and area under the curve (AUC) on SROC curve were calculated. Four studies with 237 patients and 691 lymph nodes were included. OSNA showed sensitivity = 0.88, specificity = 0.93, LR + =17.95, LR- = 0.15, DOR = 191.23 and high diagnostic accuracy (AUC = 0.959). OSNA appears as a highly accurate tool for intraoperative assessment of sentinel lymph node in endometrial cancer.

摘要

一步核酸扩增(OSNA)用于在术中检测乳腺癌前哨淋巴结转移。OSNA也被应用于子宫内膜癌,但关于其在检测子宫内膜癌淋巴结转移中诊断准确性的证据尚不明确。通过检索8个电子数据库自建库至2019年3月间检测OSNA在子宫内膜癌前哨淋巴结转移诊断准确性的研究,进行了一项系统评价和荟萃分析。病理超分期作为参考标准。计算了敏感性、特异性、阳性和阴性似然比(LR+和LR-)、诊断比值比(DOR)以及SROC曲线上的曲线下面积(AUC)。纳入了4项研究,共237例患者和691个淋巴结。OSNA的敏感性=0.88,特异性=0.93,LR+ =17.95,LR- =0.15,DOR =191.23,诊断准确性高(AUC =0.959)。OSNA似乎是一种用于术中评估子宫内膜癌前哨淋巴结的高度准确的工具。

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