无症状患者乳头溢液细胞分析的诊断准确性：文献的荟萃分析和系统评价。
Diagnostic Accuracy of Nipple Aspirate Fluid Cytology in Asymptomatic Patients: A Meta-analysis and Systematic Review of the Literature.
机构信息
Department of Surgery and Cancer, Imperial College London, London, UK.
Royal College of Surgeons Ireland, Dublin, Ireland.
出版信息
Ann Surg Oncol. 2021 Jul;28(7):3751-3760. doi: 10.1245/s10434-020-09313-9. Epub 2020 Nov 9.
PURPOSE
To calculate the diagnostic accuracy of nipple aspirate fluid (NAF) cytology.
BACKGROUND
Evaluation of NAF cytology in asymptomatic patients conceptually offers a non-invasive method for either screening for breast cancer or else predicting or stratifying future cancer risk.
METHODS
Studies were identified by performing electronic searches up to August 2019. A meta-analysis was conducted to attain an overall pooled sensitivity and specificity of NAF for breast cancer detection.
RESULTS
A search through 938 studies yielded a total of 19 studies. Overall, 9308 patients were examined, with cytology results from 10,147 breasts [age (years), mean ± SD = 49.73 ± 4.09 years]. Diagnostic accuracy meta-analysis of NAF revealed a pooled specificity of 0.97 (95% CI 0.97-0.98), and sensitivity of 0.64 (95% CI 0.62-0.66).
CONCLUSIONS
The diagnostic accuracy of nipple smear cytology is limited by poor sensitivity. If nipple fluid assessment is to be used for diagnosis, then emerging technologies for fluid biomarker analysis must supersede the current diagnostic accuracy of NAF cytology.
目的
计算乳头吸出液（NAF）细胞学的诊断准确性。
背景
对无症状患者的 NAF 细胞学评估从概念上提供了一种非侵入性的方法，用于筛查乳腺癌或预测或分层未来的癌症风险。
方法
通过截至 2019 年 8 月的电子搜索确定研究。进行荟萃分析以获得 NAF 对乳腺癌检测的总体汇总敏感性和特异性。
结果
通过 938 项研究搜索，共获得 19 项研究。总体上，对 9308 例患者进行了检查，细胞学结果来自 10147 个乳房[年龄（岁），平均值±标准差=49.73±4.09]。NAF 的诊断准确性荟萃分析显示，总体特异性为 0.97（95%CI 0.97-0.98），敏感性为 0.64（95%CI 0.62-0.66）。
结论
乳头涂片细胞学的诊断准确性受到敏感性差的限制。如果要将乳头液评估用于诊断，那么用于液体生物标志物分析的新兴技术必须超过当前 NAF 细胞学的诊断准确性。
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