Department of Ultrasound, Shandong Provincial Hospital affiliated to Shandong First Medical University, No. 324 Jing 5 Rd, Jinan, Shandong, 250021, People's Republic of China.
Breast Cancer Res Treat. 2023 Nov;202(2):221-231. doi: 10.1007/s10549-023-07063-2. Epub 2023 Jul 27.
The status of sentinel lymph nodes (SLN) is an important factor in determining the stage of breast cancer (BC) and the surgical procedure, and also a biomarker of the BC prognosis. This meta-analysis was performed to investigate the diagnostic value of contrast-enhanced ultrasound (CEUS) for SLN metastasis.
A systematic search was conducted for relevant articles published in the PubMed, Embase, Web of Science, OVID databases, and Cochrane Library from inception to March 2023. We calculated the sensitivity, specificity, positive and negative likelihood ratio (PLR; NLR), diagnostic odds ratio (DOR), and summary receiver operator characteristic (SROC) curve to evaluate the diagnostic efficacy of CEUS in SLN metastasis. Subgroup analysis was also performed to investigate potential sources of heterogeneity.
A total of 12 studies with 1525 patients were included in this meta-analysis. The overall pooled sensitivity and specificity of CEUS in the diagnosis of SLN metastasis were 0.91 (95% CI: 0.84-0.95) and 0.86 (95% CI: 0.78-0.92). The PLR, NLR, and DOR were 6.51 (95% CI: 4.09-10.36), 0.11 (95% CI: 0.07-0.18), and 59.43 (95% CI: 33.27-106.17), respectively, and the area under the SROC curve was determined to be 0.95 (95%CI: 0.92-0.96), all showing excellent diagnostic value. In the subgroup analysis, percutaneous CEUS was more sensitive than intravenous CEUS in the diagnosis of SLN metastases (0.92 versus 0.82, p < 0.05).
CEUS, especially percutaneous CEUS, is a reliable imaging technique for diagnosing SLN metastasis and providing important information in the stage management of breast cancer.
前哨淋巴结（SLN）的状态是确定乳腺癌（BC）分期和手术方式的重要因素，也是乳腺癌预后的生物标志物。本荟萃分析旨在探讨对比增强超声（CEUS）对 SLN 转移的诊断价值。
系统检索 PubMed、Embase、Web of Science、OVID 数据库和 Cochrane 图书馆自成立至 2023 年 3 月发表的相关文章。我们计算了敏感性、特异性、阳性和阴性似然比（PLR；NLR）、诊断比值比（DOR）和汇总受试者工作特征（SROC）曲线，以评估 CEUS 对 SLN 转移的诊断效能。还进行了亚组分析以探讨潜在的异质性来源。
本荟萃分析共纳入 12 项研究，共 1525 例患者。CEUS 诊断 SLN 转移的总体合并敏感性和特异性为 0.91（95%CI：0.84-0.95）和 0.86（95%CI：0.78-0.92）。PLR、NLR 和 DOR 分别为 6.51（95%CI：4.09-10.36）、0.11（95%CI：0.07-0.18）和 59.43（95%CI：33.27-106.17），SROC 曲线下面积为 0.95（95%CI：0.92-0.96），均显示出优异的诊断价值。在亚组分析中，经皮 CEUS 比静脉 CEUS 更敏感（0.92 比 0.82，p<0.05）。
CEUS，特别是经皮 CEUS，是一种可靠的诊断 SLN 转移的影像学技术，可为乳腺癌的分期管理提供重要信息。
