Zhu Shanshan, Cao Xinguang, Nabi Ghulam, Zhang Fangbin, Liu Ping, Zhang Jingwen, Guo Changqing
Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
ENdocrinology and Physiology, Institute of Nature Conservation PAS, Krakow, Poland.
Endosc Int Open. 2024 Oct 10;12(10):E1134-E1142. doi: 10.1055/a-2409-5519. eCollection 2024 Oct.
To assess the diagnostic value of contrast-enhanced endoscopic ultrasound (CE-EUS) for autoimmune pancreatitis and other solid pancreatic masses. A systematic search of PubMed, Embase, and Web of Science was performed from inception to October 2022. We calculated individual and pooled sensitivities and specificities to determine the diagnostic ability of CE-EUS. In addition, we calculated I to test for heterogeneity and explored the source of heterogeneity by meta-regression analysis. A total of 472 patients from seven eligible studies were included. The mean sensitivity and specificity of the Bivariate analysis were 0.84 (95% CI 0.71-0.92) and 0.95 (95% CI 0.84-0.99), respectively. The diagnostic advantage ratio was 107.91 (95% confidence interval [CI] 22.22-524.13), and the area under the summary receiver operating characteristics curve was 0.91 (95% CI 0.88-0.93). The overall heterogeneity of the studies is negligible (I =0, 95% CI 0-100). However, notable heterogeneity was observed in the combined specificity ( <0.01, I =74.82) and diagnostic odds ratio ( =0.05, I =51.54). The heterogeneity in these aspects could be elucidated through sensitivity analysis. Our analysis showed that CE-EUS is useful in identifying autoimmune pancreatitis. However, further large sample size, multicenter, prospective studies are needed to demonstrate its utility.
评估对比增强内镜超声（CE-EUS）对自身免疫性胰腺炎及其他胰腺实性肿块的诊断价值。从数据库建库至2022年10月，对PubMed、Embase和Web of Science进行了系统检索。我们计算了个体及合并的敏感性和特异性，以确定CE-EUS的诊断能力。此外，我们计算I²以检验异质性，并通过Meta回归分析探索异质性来源。共纳入来自7项符合条件研究的472例患者。二元分析的平均敏感性和特异性分别为0.84（95%CI 0.71-0.92）和0.95（95%CI 0.84-0.99）。诊断优势比为107.91（95%置信区间[CI] 22.22-524.13），汇总受试者工作特征曲线下面积为0.91（95%CI 0.88-0.93）。研究的总体异质性可忽略不计（I²=0，95%CI 0-100）。然而，在合并特异性（P<0.01，I²=74.82）和诊断比值比（P=0.05，I²=51.54）方面观察到显著异质性。这些方面的异质性可通过敏感性分析加以阐明。我们的分析表明，CE-EUS在识别自身免疫性胰腺炎方面是有用的。然而，需要进一步开展大样本量、多中心、前瞻性研究来证实其效用。
