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一项关于经腹超声用于胃癌评估的效用的荟萃分析。

A meta-analysis of the utility of transabdominal ultrasound for evaluation of gastric cancer.

机构信息

Department of Radiology, Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Minhou County, China.

Unimed Scientific Inc., Wuxi, China.

出版信息

Medicine (Baltimore). 2021 Aug 13;100(32):e26928. doi: 10.1097/MD.0000000000026928.

Abstract

BACKGROUND

Clinical discovery/staging of gastric cancer (GC) is crucial in designing the treatment strategies and largely decides GC patients' survival. Endoscopic ultrasonography (EUS) and computed tomography (CT) are 2 useful GC diagnosis tools. High doses of radiation associated with CT make its use limited, while the process of EUS is stressful, time-consuming, and challenging. Transabdominal ultrasound (TAUS) is a promising candidate to address these shortcomings. This study aimed to meta-analyze the diagnostic accuracy and sensitivity of TAUS in discriminating between advanced and early GCs, as well as compare its utility with other imaging techniques.Methods: Literature searches were conducted using PubMed, Web of Science, Embase, and Cochrane Library databases up to 2019. Data were analyzed using RevMan software (Cochrane Collaboration, Oxford, UK), and pooled estimates of accuracy, sensitivity, and other features were acquired. Seven papers were eventually selected for meta-analysis.

RESULTS

TAUS had distinct diagnostic efficacies for early and advanced GC patients. The accuracy and sensitivity were significantly higher in the advanced group. A high color Doppler vascularity index and a lesion larger than 1 cm were 2 features of advanced GC. Moreover, TAUS had a comparable (but slightly higher) accuracy than CT and EUS.

CONCLUSIONS

TAUS is more accurate and sensitive in diagnosing advanced GC compared to early GC. More features of advanced GC are required to improve the recognition ability. At least, TAUS can be considered as a complementary imaging diagnostic tool to CT and EUS.

摘要

背景

胃癌(GC)的临床发现/分期对于制定治疗策略至关重要,在很大程度上决定了 GC 患者的生存情况。内镜超声检查(EUS)和计算机断层扫描(CT)是两种有用的 GC 诊断工具。CT 伴随的高剂量辐射使其应用受限,而 EUS 过程具有应激性、耗时且具有挑战性。经腹超声(TAUS)是解决这些缺点的有前途的候选方法。本研究旨在通过荟萃分析 TAUS 区分晚期和早期 GC 的诊断准确性和敏感性,并比较其与其他成像技术的效用。

方法

使用 PubMed、Web of Science、Embase 和 Cochrane Library 数据库对文献进行检索,检索时间截至 2019 年。使用 RevMan 软件(Cochrane 协作组织,英国牛津)对数据进行分析,并获取准确性、敏感性和其他特征的汇总估计值。最终选择了 7 篇论文进行荟萃分析。

结果

TAUS 对早期和晚期 GC 患者具有明显的诊断效果。晚期组的准确性和敏感性明显更高。高彩色多普勒血流指数和病变大于 1cm 是晚期 GC 的两个特征。此外,TAUS 的准确性与 CT 和 EUS 相当(但略高)。

结论

与早期 GC 相比,TAUS 在诊断晚期 GC 方面更准确、更敏感。需要更多的晚期 GC 特征来提高识别能力。至少,TAUS 可以被认为是 CT 和 EUS 的补充成像诊断工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5c0/8360412/148a5dde8e67/medi-100-e26928-g001.jpg

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