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多排螺旋CT在诊断肝脏结节性病变、胃癌和克罗恩病中的临床应用:一项综合荟萃分析。

Clinical utility of multi-row spiral CT in diagnosing hepatic nodular lesions, gastric cancer, and Crohn's disease: a comprehensive meta-analysis.

作者信息

Xu Ming, Chen Yinyun, Liu Dan, Wang Lile, Wu Minghao

机构信息

Department of Gastroenterology Medicine, Hunan Provincial People's Hospital/The First Affiliated Hospital of Hunan Normal University Changsha 410016, Hunan, China.

Department of Respiratory Medicine, Hunan Provincial People's Hospital/The First Affiliated Hospital of Hunan Normal University Changsha 410016, Hunan, China.

出版信息

Am J Clin Exp Immunol. 2024 Aug 25;13(4):165-176. doi: 10.62347/SREJ4505. eCollection 2024.

Abstract

A retrieval of relevant literature on hepatic nodular lesions, gastric cancer (GC), and Crohn's disease (CD) was conducted from Chinese and English databases. Meta-analysis was performed using Review Manager 5.4 software and the MIDAS package in Stata 18.0. Results from 11 studies comprising 1847 patients were synthesized. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio with 95% confidence intervals were: 0.91 (0.84-0.95), 0.73 (0.65-0.79), 3.30 (2.60-4.30), 0.13 (0.07-0.23), and 26.00 (12.00-53.00), respectively. Significant statistical heterogeneity was found in sensitivity and specificity (P<0.05), with specificity heterogeneity originating from n, type, and mode (P<0.05). Sensitivity and specificity for n, type, object, and mode were non-heterogeneous (P>0.05). The combined AUC from SROC curve analysis of the 11 studies was 0.85. Deeks' funnel plot asymmetry test yielded a -value of 0.01, indicating potential bias across studies in the diagnostic odds ratio funnel plot. Fagan's nomogram demonstrated that using CT for diagnostic modeling increased the post-test probability of correctly diagnosing hepatic nodular lesions, GC, and CD from 50.00% to 77.00%. Overall, multi-detector CT shows good diagnostic value for hepatic nodular lesions, GC, and CD, supporting its clinical flexibility based on patient-specific considerations.

摘要

从中文和英文数据库中检索了有关肝结节性病变、胃癌(GC)和克罗恩病(CD)的相关文献。使用Review Manager 5.4软件和Stata 18.0中的MIDAS软件包进行荟萃分析。综合了11项研究的结果,共纳入1847例患者。合并敏感度、特异度、阳性似然比、阴性似然比及诊断比值比(95%置信区间)分别为:0.91(0.84 - 0.95)、0.73(0.65 - 0.79)、3.30(2.60 - 4.30)、0.13(0.07 - 0.23)和26.00(12.00 - 53.00)。在敏感度和特异度方面发现显著的统计学异质性(P<0.05),特异度异质性源于样本量、类型和模式(P<0.05)。样本量、类型、对象和模式的敏感度和特异度无统计学异质性(P>0.05)。11项研究的SROC曲线分析合并AUC为0.85。Deeks漏斗图不对称检验的P值为0.01,表明诊断比值比漏斗图中各研究间可能存在偏倚。Fagan列线图显示,使用CT进行诊断建模可将肝结节性病变、GC和CD的正确诊断验后概率从50.00%提高到77.00%。总体而言,多排CT对肝结节性病变、GC和CD具有良好的诊断价值,支持基于患者具体情况的临床灵活性。

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Role of diet in prevention versus treatment of Crohn's disease and ulcerative colitis.饮食在克罗恩病和溃疡性结肠炎预防与治疗中的作用。
Frontline Gastroenterol. 2024 Jan 9;15(3):247-257. doi: 10.1136/flgastro-2023-102417. eCollection 2024 May.

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