Wu Jiangfeng, Zhou Zhijuan, Wang Xiaoyun, Jin Yun, Wang Zhengping, Jin Guilong
Department of Ultrasound, Dongyang Hospital of Wenzhou Medical University, Dongyang, China.
Department of Ultrasound, Tianxiang East Hospital, Yiwu, China.
Front Oncol. 2022 Sep 20;12:954751. doi: 10.3389/fonc.2022.954751. eCollection 2022.
The clinical practice of elastosonography for the detection of salivary gland tumors is still a controversial issue. The objective of this meta-analysis was to evaluate the effect of elastosonography for the diagnosis of salivary gland tumors and to compare the diagnostic value of elastosonography and conventional ultrasound in the diagnosis of salivary gland tumors.
A comprehensive literature search through PubMed, EMBASE, and Cochrane Library was carried out from inception to November 2021. Two researchers independently extracted the data from the enrolled papers using a standard data extraction form. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) were calculated to evaluate the diagnostic performance of elastosonography. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was utilized to evaluate the quality of each included study. Meta-DiSc version 1.4, Review Manager 5.3, and StataSE 15 were used.
Sixteen studies with a total of 1105 patients with 1146 lesions were included in this meta-analysis. The pooled sensitivity, specificity, PLR, NLR, and DOR of elastosonography for the differentiation between benign and malignant salivary gland tumors were 0.73 (95%CI, 0.66-0.78), 0.64 (95%CI, 0.61-0.67), 2.83 (95%CI, 1.97-4.07), 0.45 (95%CI, 0.32-0.62), and 9.86 (95%CI, 4.49-21.62), respectively, with an AUC of 0.82. Four studies provided data regarding the conventional ultrasound for the differentiation between benign and malignant salivary gland tumors. The pooled sensitivity, specificity, and DOR were 0.62 (95%CI, 0.50-0.73), 0.93 (95%CI, 0.90-0.96), and 25.07 (95%CI, 4.28-146.65), respectively. The meta-regression and subgroup analyses found that assessment methods were associated with significant heterogeneity, and quantitative or semiquantitative elastosonography performed better than the qualitative one.
Elastosonography showed a limited value for diagnosing malignant salivary gland tumors; it could be considered as a supplementary diagnostic technology to conventional ultrasound, and quantitative or semiquantitative elastosonography was superior to the qualitative one.
弹性超声检查在涎腺肿瘤检测中的临床应用仍是一个有争议的问题。本荟萃分析的目的是评估弹性超声检查对涎腺肿瘤诊断的效果，并比较弹性超声检查与传统超声在涎腺肿瘤诊断中的价值。
从创刊至2021年11月，通过PubMed、EMBASE和Cochrane图书馆进行了全面的文献检索。两名研究人员使用标准的数据提取表从纳入的论文中独立提取数据。计算合并敏感度、特异度、阳性似然比（PLR）、阴性似然比（NLR）、诊断比值比（DOR）和曲线下面积（AUC），以评估弹性超声检查的诊断性能。使用诊断准确性研究质量评估-2（QUADAS-2）工具评估每项纳入研究的质量。使用Meta-DiSc 1.4版、Review Manager 5.3版和StataSE 15版软件进行分析。
本荟萃分析纳入了16项研究，共1105例患者，1146个病灶。弹性超声检查在鉴别涎腺良性和恶性肿瘤方面的合并敏感度、特异度、PLR、NLR和DOR分别为0.73（95%CI，0.66-0.78）、0.64（95%CI，0.61-0.67）、2.83（95%CI，1.97-4.07）、0.45（95%CI，0.32-0.62）和9.86（95%CI，4.49-21.62），AUC为0.82。四项研究提供了关于传统超声鉴别涎腺良性和恶性肿瘤的数据。合并敏感度、特异度和DOR分别为0.62（95%CI，0.50-0.73）、0.93（95%CI，0.90-0.96）和25.07（95%CI，4.28-146.65）。Meta回归和亚组分析发现，评估方法存在显著异质性，定量或半定量弹性超声检查的表现优于定性弹性超声检查。
弹性超声检查在诊断涎腺恶性肿瘤方面价值有限；可将其视为传统超声的补充诊断技术，且定量或半定量弹性超声检查优于定性弹性超声检查。
