Qian Qinyi, Gu Xinxian, Shi Bo, Shen Chen, Xu Yinkai, Gu Wen
Department of Ultrasound, The Fourth Affiliated Hospital of Soochow University Suzhou, Jiangsu, China.
Department of General Surgery, The First Affiliated Hospital of Soochow University Suzhou, Jiangsu, China.
Am J Transl Res. 2025 May 15;17(5):3830-3841. doi: 10.62347/BJMS2565. eCollection 2025.
Timely and precise diagnosis of rectal tumors is pivotal for improving patient outcomes. Despite advances in imaging technologies, differentiating benign adenomas from early-stage rectal cancer remains a significant challenge. The aim of this study was to assess the effectiveness of endorectal ultrasound (ERUS) elastography in differentiating rectal adenomas from cancer.
In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search of the PubMed, Embase, and Cochrane databases was performed to identify studies that used ERUS elastography to assess rectal adenomas and cancer. A random effects model was employed to pool the sensitivity, specificity, and diagnostic odds ratio (DOR) for ERUS elastography in the diagnosis of rectal tumors.
Ten studies encompassing a total of 722 patients with rectal tumors were included in this meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and DOR of ERUS elastography for distinguishing benign from malignant rectal tumors were 93% (95% confidence intervals (CI), 88%-96%), 86% (95% CI, 78%-92%), 6.71 (95% CI, 4.14-10.86), 0.08 (95% CI, 0.05-0.14), and 84 (95% CI, 38-186), respectively. The summary receiver operating characteristic (SROC) curve demonstrated an area under the curve (AUC) of 0.95 (95% CI, 0.93-0.97).
ERUS elastography greatly enhances diagnostic precision by distinguishing rectal adenomas from cancer, providing an effective approach to differentiate benign from malignant rectal lesions.
直肠肿瘤的及时、准确诊断对于改善患者预后至关重要。尽管成像技术取得了进展，但区分良性腺瘤与早期直肠癌仍然是一项重大挑战。本研究的目的是评估直肠超声（ERUS）弹性成像在区分直肠腺瘤与癌症方面的有效性。
按照系统评价和Meta分析的首选报告项目（PRISMA）指南，对PubMed、Embase和Cochrane数据库进行全面检索，以识别使用ERUS弹性成像评估直肠腺瘤和癌症的研究。采用随机效应模型汇总ERUS弹性成像在直肠肿瘤诊断中的敏感性、特异性和诊断比值比（DOR）。
本Meta分析纳入了10项研究，共722例直肠肿瘤患者。ERUS弹性成像区分直肠良性与恶性肿瘤的汇总敏感性、特异性、阳性似然比（PLR）、阴性似然比（NLR）和DOR分别为93%（95%置信区间（CI），88%-96%）、86%（95%CI，78%-92%）、6.71（95%CI，4.14-10.86）、0.08（95%CI，0.05-0.14）和84（95%CI，38-186）。汇总的受试者工作特征（SROC）曲线显示曲线下面积（AUC）为0.95（95%CI，0.93-0.97）。
ERUS弹性成像通过区分直肠腺瘤与癌症大大提高了诊断准确性，为区分直肠良性与恶性病变提供了一种有效方法。
