He Shuyan, Chen Cuie, Wang Zhigang, Yu Xiaodan, Liu Shuhong, Huang Zhouliang, Chen Cuijiao, Liang Zhu, Chen Chunyuan
Guangzhou Medical University, Panyu District, Guangzhou, Guangdong Province, China.
Guangdong Medical University, Xiashan District, ZhanJiang, Guangdong Province, China.
Asian J Surg. 2023 Feb;46(2):677-682. doi: 10.1016/j.asjsur.2022.07.031. Epub 2022 Jul 19.
The invasiveness of ground-glass nodules (GGNs) is difficult to characterize through morphological examination. Multiple studies have independently detected a close relationship between mean computed tomography value and invasiveness of GGNs, however, their relative diagnostic accuracy is uncertain. Here, we performed a meta-analysis to validate whether the mean computed tomography value can predict the invasiveness of GGNs. Briefly, we searched the Web of Science, Embase, PubMed, Cochrane, Google Scholar, CNKI, VIP, Wanfang and SinoMed databases. The sensitivity, specificity, 95% confidence interval (CI), symmetric receiver operating characteristic curve (SROC curve) and the area under curve (AUC) were obtained using STATA 16.0 to evaluate the predictive value of the mean computed tomography value for GGNs. The presence of heterogeneity was assessed using fixed effects sensitivity analysis and I statistics. We used the Deek's funnel plot to evaluate the possibility of publication bias. Thirteen studies encompassing 1564 GGNs were included in our meta-analysis. Six of these studies revealed that using the mean computed tomography value for the diagnosis of pre-invasive and invasive lesions had a sensitivity and specificity of 0.75 (95% CI: 0.61-0.85) and 0.81 (95% CI: 0.74-0.86), respectively. The optimal critical value was -557 Hu. Later, eight studies were examined for the use of the mean CT value for patients with minimally invasive adenocarcinoma (MIA) and invasive adenocarcinoma (IAC); the results showed that the sensitivity was 0.78 (95% CI: 0.66-0.86) and the specificity was 0.81 (95% CI: 0.68-0.89), and the optimal critical value was -484 Hu. Therefore, the mean computed tomography value assessed via CT scan could be a significant predictor of the invasiveness of GGNs as well as a good surgical treatment guide in patients diagnosed with lung cancer. PROSPERO REGISTRATION NUMBER: CRD42020177125.
磨玻璃结节（GGNs）的侵袭性很难通过形态学检查来表征。多项研究已独立检测到计算机断层扫描平均密度值与GGNs侵袭性之间存在密切关系，然而，它们的相对诊断准确性尚不确定。在此，我们进行了一项荟萃分析，以验证计算机断层扫描平均密度值是否能够预测GGNs的侵袭性。简要地说，我们检索了Web of Science、Embase、PubMed、Cochrane、谷歌学术、中国知网、维普、万方和中国生物医学文献数据库。使用STATA 16.0获得敏感性、特异性、95%置信区间（CI）、对称受试者工作特征曲线（SROC曲线）和曲线下面积（AUC），以评估计算机断层扫描平均密度值对GGNs的预测价值。使用固定效应敏感性分析和I统计量评估异质性的存在。我们使用Deek漏斗图评估发表偏倚的可能性。我们的荟萃分析纳入了13项研究，共1564个GGNs。其中6项研究表明，使用计算机断层扫描平均密度值诊断浸润前和浸润性病变的敏感性和特异性分别为0.75（95%CI：0.61-0.85）和0.81（95%CI：0.74-0.86）。最佳临界值为-557 Hu。随后，对8项研究进行了检查，以了解计算机断层扫描平均密度值在微浸润腺癌（MIA）和浸润性腺癌（IAC）患者中的应用；结果显示敏感性为0.78（95%CI：0.66-0.86），特异性为0.81（95%CI：0.68-0.89），最佳临界值为-484 Hu。因此，通过CT扫描评估的计算机断层扫描平均密度值可能是GGNs侵袭性的重要预测指标，也是诊断为肺癌患者的良好手术治疗指导。PROSPERO注册号：CRD42020177125。
