乳腺 X 线摄影与超声检查在乳腺癌诊断中的性能：系统评价和荟萃分析。
Diagnostic performance of mammography and ultrasound in breast cancer: a systematic review and meta-analysis.
机构信息
Department of Internal Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Department of Physics, Faculty of Natural Sciences, Debre Tabor University, Debra Tabor, Ethiopia.
出版信息
J Ultrasound. 2023 Jun;26(2):355-367. doi: 10.1007/s40477-022-00755-3. Epub 2023 Jan 25.
PURPOSE
The purpose of this study was to assess the diagnostic performance of mammography (MMG) and ultrasound (US) imaging for detecting breast cancer.
METHODS
Comprehensive searches of PubMed, Scopus and EMBASE from 2008 to 2021 were performed. A summary receiver operating characteristic curve (SROC) was constructed to summarize the overall test performance of MMG and US. Histopathologic analysis and/or close clinical and imaging follow-up for at least 6 months were used as golden reference.
RESULTS
Analysis of the studies revealed that the overall validity estimates of MMG and US in detecting breast cancer were as follows: pooled sensitivity per-patient were 0.82 (95% CI 0.76-0.87) and 0.83 (95% CI 0.71-0.91) respectively, The pooled specificities for detection of breast cancer using MMG, and US were 0.84 (95% CI 0.73-0.92) and 0.84 (95% CI 0.74-0.91) respectively. AUC of MMG, and US were 0.8933 and 0.8310 respectively. Pooled sensitivity and specificity per-lesion was 76% (95% CI 0.62-0.86) and 82% (95% CI 0.66-0.91) for MMG and 94% (95% CI 0.87-0.97) and 84% (95% CI 0.74-0.91) for US.
CONCLUSIONS
The meta-analysis found that, US and MMG has similar diagnostic performance in detecting breast cancer on per-patient basis after corrected threshold effect. However, on a per-lesion basis US was found to have a better diagnostic accuracy than MMG.
目的
本研究旨在评估乳腺摄影（MMG）和超声（US）成像在乳腺癌检测中的诊断性能。
方法
对 2008 年至 2021 年期间的 PubMed、Scopus 和 EMBASE 进行全面检索。构建了汇总受试者工作特征曲线（SROC），以总结 MMG 和 US 的总体检测性能。采用组织病理学分析和/或至少 6 个月的密切临床和影像学随访作为金标准。
结果
对研究的分析表明，MMG 和 US 检测乳腺癌的总体有效性估计值如下：每位患者的汇总敏感性分别为 0.82（95%置信区间 0.76-0.87）和 0.83（95%置信区间 0.71-0.91），使用 MMG 和 US 检测乳腺癌的汇总特异性分别为 0.84（95%置信区间 0.73-0.92）和 0.84（95%置信区间 0.74-0.91）。MMG 和 US 的 AUC 分别为 0.8933 和 0.8310。MMG 的汇总敏感性和特异性分别为 76%（95%置信区间 0.62-0.86）和 82%（95%置信区间 0.66-0.91），US 的敏感性和特异性分别为 94%（95%置信区间 0.87-0.97）和 84%（95%置信区间 0.74-0.91）。
结论
荟萃分析发现，在纠正阈值效应后，基于每位患者，US 和 MMG 在乳腺癌检测方面具有相似的诊断性能。然而，基于每例病变，US 的诊断准确性优于 MMG。
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