非侵入性诊断方法在口腔癌和癌前病变的诊断和筛查中的应用效果。

Efficacy of non-invasive diagnostic methods in the diagnosis and screening of oral cancer and precancer.

机构信息

The Catholic University of Korea, College of Medicine, Seoul St. Mary's Hospital, Department of Otolaryngology-Head and Neck Surgery, Seoul, Republic of Korea.

The Catholic University of Korea, College of Medicine, Bucheon St. Mary's Hospital, Department of Otolaryngology-Head and Neck Surgery, Seoul, Republic of Korea.

出版信息

Braz J Otorhinolaryngol. 2022 Nov-Dec;88(6):937-947. doi: 10.1016/j.bjorl.2020.12.019. Epub 2021 Feb 13.

DOI:10.1016/j.bjorl.2020.12.019

PMID:33642212

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9615541/

Abstract

INTRODUCTION

Traditional meta-analyses on the diagnostic accuracy of oral lesions have been conducted, but they were inherently limited to direct pairwise comparisons between a single method and a single alternative, while multiple diagnostic options and the ranking thereof were methodologically not possible.

OBJECTIVE

To evaluate the diagnostic values of various methods in patients with oral potential malignant disease by performing a network meta-analysis.

METHODS

Two authors independently searched the databases (MEDLINE, SCOPUS, the Cochrane Register of Controlled Trials, and Google scholar) up to June 2020 for studies comparing the diagnostic accuracy of various tools (autofluorescence, chemiluminescence, cytology, narrow band imaging, and toluidine blue) with visual examination or other tools. The outcomes of interest for this analysis were sensitivity, specificity, negative predictive value, positive predictive value and accuracy. Both a standard pairwise meta-analysis and network meta-analysis were conducted.

RESULTS

Treatment networks consisting of six interventions were defined for the network meta-analysis. The results of traditional meta-analysis showed that, among six methods, narrow band imaging showed higher sensitivity, specificity, negative predictive value, positive predictive value, and accuracy compared to visual examination. The results of network meta-analysis showed that autofluorescence, chemiluminescence, and narrow band imaging had higher sensitivity compared with visual examination, and that chemiluminescence and narrow band imaging had higher negative predictive value compared with visual examination. However, autofluorescence and chemiluminescence had lower specificity compared with visual examination. There were no significant differences in positive predictive value and accuracy among the six interventions.

CONCLUSION

This study demonstrated that narrow banding imaging has superiority in terms of sensitivity and negative predictive value compared with the other five tested agents.

摘要

简介

传统的口腔病变诊断准确性的荟萃分析已经进行，但它们本质上仅限于对单一方法和单一替代方法之间的直接两两比较，而多个诊断选择及其排序在方法学上是不可能的。

目的

通过进行网络荟萃分析来评估各种方法在口腔潜在恶性疾病患者中的诊断价值。

方法

两位作者独立检索数据库（MEDLINE、SCOPUS、Cochrane 对照试验登记册和 Google Scholar），以比较各种工具（荧光、化学发光、细胞学、窄带成像和甲苯胺蓝）与视觉检查或其他工具的诊断准确性的研究，截止日期为 2020 年 6 月。本分析的感兴趣结果是敏感性、特异性、阴性预测值、阳性预测值和准确性。进行了标准的两两荟萃分析和网络荟萃分析。

结果

为网络荟萃分析定义了包含六种干预措施的治疗网络。传统荟萃分析的结果表明，在六种方法中，窄带成像在敏感性、特异性、阴性预测值、阳性预测值和准确性方面均优于视觉检查。网络荟萃分析的结果表明，荧光、化学发光和窄带成像的敏感性均高于视觉检查，而化学发光和窄带成像的阴性预测值均高于视觉检查。然而，荧光和化学发光的特异性低于视觉检查。六种干预措施之间的阳性预测值和准确性没有显著差异。