Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, Guangzhou, Guangdong, 510055, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, No.74, 2nd Zhongshan Road, Guangzhou, 510080, Guangdong, China.
Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, Guangzhou, Guangdong, 510055, China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, No.74, 2nd Zhongshan Road, Guangzhou, 510080, Guangdong, China.
Int J Oral Maxillofac Surg. 2020 Sep;49(9):1128-1134. doi: 10.1016/j.ijom.2019.11.014. Epub 2020 Mar 6.
A clear bone margin is essential for complete resection of the bone-involved tumour, but the evaluation of hard tissue takes time and is impractical intraoperatively. Bone marrow assessment remains controversial. The aim of this study was to investigate the diagnostic value of intraoperative bone marrow assessment for bone margins. PubMed and Web of Science were searched for studies published between 1990 and 2017. A systematic review was conducted. After quality assessment, 10 articles with 11 cohorts and 404 patients were identified. Sensitivity, specificity, and other measures were pooled for meta-analysis; the estimates for intraoperative bone marrow assessment were as follows: sensitivity 0.82 (95% confidence interval (CI) 0.62-0.93), specificity 0.99 (95% CI 0.96-1.00), positive likelihood ratio 109.79 (95% CI 22.99-524.34), negative likelihood ratio 0.18 (95% CI 0.08-0.42), and diagnostic odds ratio 241.82 (95% CI 90.33-647.38). Furthermore, sensitivity and specificity at the summary operating point of the summary receiver operating characteristic curve were 0.82 and 0.99, respectively, and the area under the curve was 0.99. Intraoperative bone marrow assessment was investigated by meta-analysis and shown to have a high level of overall accuracy for the diagnosis of bone margins.
对于骨内肿瘤的完整切除，清晰的骨缘至关重要，但评估硬组织需要时间，在术中并不实用。骨髓评估仍然存在争议。本研究旨在探讨术中骨髓评估对骨切缘的诊断价值。通过 PubMed 和 Web of Science 检索了 1990 年至 2017 年期间发表的研究。进行了系统评价。经过质量评估，确定了 10 篇文章，共 11 个队列，涉及 404 名患者。对meta 分析进行了汇总敏感性、特异性和其他指标的评估；术中骨髓评估的估计值如下：敏感性 0.82（95%置信区间（CI）0.62-0.93），特异性 0.99（95% CI 0.96-1.00），阳性似然比 109.79（95% CI 22.99-524.34），阴性似然比 0.18（95% CI 0.08-0.42），诊断比值比 241.82（95% CI 90.33-647.38）。此外，汇总受试者工作特征曲线的汇总检测点的敏感性和特异性分别为 0.82 和 0.99，曲线下面积为 0.99。通过荟萃分析研究了术中骨髓评估，结果表明其对骨切缘的诊断具有较高的整体准确性。
