Department of Radiotherapy, Tangdu Hospital, 56697Air Force Military Medical University, Xi'an, China.
Cancer Control. 2021 Jan-Dec;28:10732748211059858. doi: 10.1177/10732748211059858.
To evaluate the diagnostic yield and safety of brainstem stereotactic biopsy for brainstem lesions.
We performed a meta-analysis of English articles retrieved from the PubMed, Web of Science, Cochrane Library, and APA psycInfo databases up to May 12, 2021. A binary fixed-effect model, the inverse variance method, or a binary random-effect model, the Dersimonian Laird method, were utilized for pooling the data. This meta-analysis was registered with INPLASY, INPLASY202190034.
A total of 41 eligible studies with 2792 participants were included. The weighted average diagnostic yield was 97.0% (95% confidential interval [CI], 96.0-97.9%). The weighted average proportions of temporary complications, permanent deficits, and deaths were 6.2% (95% CI, 4.5-7.9%), .5% (95% CI, .2-.8%), and .3% (95% CI, .1-.5%), respectively. The subgroup analysis indicated a nearly identical weighted average diagnostic yield between MRI-guided stereotactic biopsy and CT-guided stereotactic biopsy (95.9% vs 95.8%) but slightly increased proportions of temporary complications (7.9% vs 6.0%), permanent deficits (1.9% vs .2%), and deaths (1.1% vs .4%) in the former compared to the latter. Moreover, a greater weighted average diagnostic yield (99.2% vs 97.6%) and lower proportions of temporary complications (5.1% vs 6.8%) and deaths (.7% vs 1.5%) were shown in the pediatric patient population than in the adult patient population.
Brainstem stereotactic biopsy demonstrates striking accuracy plus satisfying safety in the diagnosis of brainstem lesions. The diagnostic yield, morbidity, and mortality mildly vary based on the diversity of assistant techniques and subject populations.
评估脑立体定向活检对脑干病变的诊断效果和安全性。
我们对截至 2021 年 5 月 12 日从 PubMed、Web of Science、Cochrane Library 和 APA psycInfo 数据库中检索到的英文文章进行了荟萃分析。采用二项固定效应模型、倒数方差法或二项随机效应模型、Dersimonian Laird 法对数据进行汇总。本荟萃分析已在 INPLASY 注册，注册号为 INPLASY202190034。
共有 41 项符合条件的研究纳入 2792 名参与者。加权平均诊断率为 97.0%（95%可信区间[CI]，96.0-97.9%）。加权平均临时并发症、永久性损伤和死亡率分别为 6.2%（95%CI，4.5-7.9%）、0.5%（95%CI，0.2-0.8%）和 0.3%（95%CI，0.1-0.5%）。亚组分析表明，MRI 引导下立体定向活检与 CT 引导下立体定向活检的加权平均诊断率几乎相同（95.9%比 95.8%），但前者的临时并发症比例略有增加（7.9%比 6.0%）、永久性损伤（1.9%比 0.2%）和死亡率（1.1%比 0.4%）。此外，在儿科患者人群中，加权平均诊断率更高（99.2%比 97.6%），临时并发症（5.1%比 6.8%）和死亡率（0.7%比 1.5%）更低。
脑立体定向活检在诊断脑干病变方面具有显著的准确性和良好的安全性。诊断效果、发病率和死亡率在不同辅助技术和研究人群中略有不同。
