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双侧岩下窦采样（BIPSS）在 ACTH 依赖性库欣综合征中的鉴别诊断价值：系统评价和 Meta 分析。

Differential diagnostic value of bilateral inferior Petrosal sinus sampling (BIPSS) in ACTH-dependent Cushing syndrome: a systematic review and Meta-analysis.

机构信息

Department of Endocrinology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China.

出版信息

BMC Endocr Disord. 2020 Sep 17;20(1):143. doi: 10.1186/s12902-020-00623-3.

DOI:10.1186/s12902-020-00623-3
PMID:32943040
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7499975/
Abstract

BACKGROUND

Previous studies have shown inconsistent results about the usefulness of bilateral inferior petrosal sinus sampling (BIPSS) in differential diagnosis of adrenocorticotropic hormone (ACTH)-dependent Cushing syndrome. This meta-analysis evaluated the diagnostic value of BIPSS via the published literature.

METHODS

This study searched PubMed, Embase, Web of Science, Cochrane library, and Wanfang database for published data on the use of BIPSS in Cushing syndrome differential diagnosis as of October 2019. Sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and receiver operating characteristic (ROC) curves were calculated based on the relevant data.

RESULTS

This meta-analysis included a total of 23 studies with 1642 patients. The calculated sensitivity, specificity, PLR, and NLR were 0.94 (95% confidence interval, CI: 0.91-0.96), 0.89 (95% CI: 0.79-0.95), 8.8 (95% CI: 4.3-17.9), and 0.07 (95% CI: 0.04-0.11), respectively. The pooled DOR and area under the ROC curve were 129 (95% CI: 48-345) and 0.97 (95% CI: 0.95-0.98), respectively.

CONCLUSION

This meta-analysis indicated that BIPSS had high diagnostic value for detecting ACTH in patients with ACTH-dependent Cushing syndrome, and BIPSS should be used as an effective method to identify ACTH-secretion sources.

摘要

背景

之前的研究表明，双侧岩下窦取样（BIPSS）在鉴别促肾上腺皮质激素（ACTH）依赖性库欣综合征方面的作用结果不一致。本荟萃分析通过已发表的文献评估了 BIPSS 的诊断价值。

方法

本研究检索了截至 2019 年 10 月发表的关于 BIPSS 在库欣综合征鉴别诊断中应用的 PubMed、Embase、Web of Science、Cochrane 图书馆和万方数据库中的数据。根据相关数据计算了敏感性、特异性、阳性似然比（PLR）、阴性似然比（NLR）、诊断比值比（DOR）和受试者工作特征（ROC）曲线。

结果

本荟萃分析共纳入了 23 项研究，共计 1642 例患者。计算得到的敏感性、特异性、PLR 和 NLR 分别为 0.94（95%置信区间：0.91-0.96）、0.89（95%置信区间：0.79-0.95）、8.8（95%置信区间：4.3-17.9）和 0.07（95%置信区间：0.04-0.11）。汇总的 DOR 和 ROC 曲线下面积分别为 129（95%置信区间：48-345）和 0.97（95%置信区间：0.95-0.98）。

结论

本荟萃分析表明，BIPSS 对检测 ACTH 依赖性库欣综合征患者的 ACTH 具有较高的诊断价值，BIPSS 应作为一种有效的方法来识别 ACTH 分泌源。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4a8/7499975/b16a578db623/12902_2020_623_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4a8/7499975/4fa396588b33/12902_2020_623_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4a8/7499975/966cbad636d2/12902_2020_623_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4a8/7499975/470f17e34446/12902_2020_623_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4a8/7499975/b16a578db623/12902_2020_623_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4a8/7499975/4fa396588b33/12902_2020_623_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4a8/7499975/966cbad636d2/12902_2020_623_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4a8/7499975/470f17e34446/12902_2020_623_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4a8/7499975/b16a578db623/12902_2020_623_Fig6_HTML.jpg

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