医学胸腔镜检查、计算机断层扫描引导下活检及超声引导下活检用于恶性胸膜间皮瘤：一项系统评价
Medical Thoracoscopy, Computed Tomography-guided Biopsy, and Ultrasound-guided Biopsy for Malignant Pleural Mesothelioma: A Systematic Review.
作者信息
Shiroshita Akihiro, Kurosaki Motohiro, Takeshita Masafumi, Kataoka Yuki
机构信息
Department of Respiratory Medicine, Ichinomiyanishi Hospital, Ichinomiya, Japan;
Post Graduate Education Center, Kameda Medical Center, Kamogawa, Japan.
出版信息
Anticancer Res. 2021 May;41(5):2217-2225. doi: 10.21873/anticanres.14998.
BACKGROUND/AIM: Although surgical thoracoscopy is recommended in the diagnosis of malignant pleural mesothelioma (MPM), the invasiveness of this procedure is of strong concern. Our review aimed to evaluate the accuracies of medical thoracoscopy (MT), computed tomography (CT)-guided biopsy, and ultrasound (US)-guided biopsy in the diagnosis of MPM among patients with pleural effusion.
MATERIALS AND METHODS
We searched the MEDLINE, Embase, Central, and International Clinical Trials Registry Platform databases for studies evaluating the diagnostic accuracy of at least one of the biopsy procedures among patients with pleural effusion of unknown aetiology who had undergone thoracentesis and/or blind biopsy. A hierarchical summary receiver operating curve was created for MT.
RESULTS
Following full-text screening, 15 studies were included. MT studies had a high risk of bias and low applicability concern; however, hierarchical summary receiver operating curve revealed that MT had a high sensitivity.
CONCLUSION
MT might be a useful rule-in test for guiding the use of more invasive diagnostic procedures.
背景/目的：虽然建议采用外科胸腔镜检查来诊断恶性胸膜间皮瘤（MPM），但该检查的侵入性备受关注。我们的综述旨在评估内科胸腔镜检查（MT）、计算机断层扫描（CT）引导下活检以及超声（US）引导下活检在胸腔积液患者中诊断MPM的准确性。
材料与方法
我们检索了MEDLINE、Embase、CENTRAL和国际临床试验注册平台数据库，以查找评估在接受胸腔穿刺术和/或盲目活检的病因不明胸腔积液患者中至少一种活检程序诊断准确性的研究。为MT创建了分层汇总接受者操作特征曲线。
结果
经过全文筛选，纳入了15项研究。MT研究存在高偏倚风险和低适用性问题；然而，分层汇总接受者操作特征曲线显示MT具有高敏感性。
结论
MT可能是一种有用的确诊试验，可用于指导采用更具侵入性的诊断程序。
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