放大窄带成像对早期胃癌范围的诊断能力：一项系统评价和Meta分析
Diagnostic Ability of Magnifying Narrow-Band Imaging for the Extent of Early Gastric Cancer: A Systematic Review and Meta-Analysis.
作者信息
Hu Yingying, Chen Xueqin, Hendi Maher, Si Jianmin, Chen Shujie, Deng Yanyong
机构信息
Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
Institution of Gastroenterology, Zhejiang University, Hangzhou, Zhejiang Province, China.
出版信息
Gastroenterol Res Pract. 2021 Apr 23;2021:5543556. doi: 10.1155/2021/5543556. eCollection 2021.
BACKGROUND
Accurate delineation of tumor margin is essential for complete resection of early gastric cancer (EGC). The objective of this study is to assess the performance of magnifying endoscopy with narrow-band imaging (ME-NBI) for the accurate demarcation of EGC margins.
METHODS
We searched PubMed, EMBASE, Web of Science, and Cochrane Library databases up to March 2020 to identify eligible studies. The diagnostic accuracy of ME-NBI for EGC margins was calculated, and subgroup analyses were performed based on tumor size, depth of tumor invasion, tumor-occupied site, macroscopic type, histological type, (), and endoscopists' experience. Besides, we also evaluated the negative and positive resection rates of the horizontal margin (HM) of EGC after endoscopic submucosal dissection (ESD) and surgery.
RESULTS
Ten studies comprising 1018 lesions were eligible in the databases. The diagnostic accuracy of ME-NBI for the demarcation of EGC margins was 92.4% (95% confidence interval (CI): 86.7%-96.8%). According to ME-NBI subgroup analyses, the rate of accurate evaluation of EGC margins was not associated with infection status, tumor size, depth of tumor invasion, tumor-occupied site, macroscopic type, histological type, and endoscopists' experience, and no statistical differences were found in subgroup analyses. Moreover, the negative and positive resection rates of HM after ESD and surgery were 97.4% (95% CI: 92.1%-100%) and 2.6% (95% CI: 0.02%-7.9%), respectively.
CONCLUSIONS
ME-NBI enables a reliable delineation of the extent of EGC.
背景
准确界定肿瘤边界对于早期胃癌（EGC）的完整切除至关重要。本研究的目的是评估窄带成像放大内镜（ME-NBI）在准确划分EGC边界方面的性能。
方法
我们检索了截至2020年3月的PubMed、EMBASE、Web of Science和Cochrane图书馆数据库，以确定符合条件的研究。计算ME-NBI对EGC边界的诊断准确性，并根据肿瘤大小、肿瘤浸润深度、肿瘤所在部位、大体类型、组织学类型、（此处原文括号内容缺失）以及内镜医师的经验进行亚组分析。此外，我们还评估了内镜黏膜下剥离术（ESD）和手术后EGC水平切缘（HM）的阴性和阳性切除率。
结果
数据库中有10项研究共1018个病变符合条件。ME-NBI对EGC边界划分的诊断准确性为92.4%（95%置信区间（CI）：86.7%-96.8%）。根据ME-NBI亚组分析，EGC边界的准确评估率与感染状况、肿瘤大小、肿瘤浸润深度、肿瘤所在部位、大体类型、组织学类型以及内镜医师的经验无关，亚组分析未发现统计学差异。此外，ESD和手术后HM的阴性和阳性切除率分别为97.4%（95%CI：92.1%-100%）和2.6%（95%CI：0.02%-7.9%）。
结论
ME-NBI能够可靠地界定EGC的范围。
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