超声造影对乳腺良恶性肿瘤鉴别诊断价值的系统评价

发布时间：2018-05-20 20:38

本文选题：乳腺肿瘤 + 超声造影　；参考：《新疆医科大学》2014年硕士论文

【摘要】：目的：采用Meta分析方法评价超声造影在乳腺良恶性肿瘤诊断中的临床应用价值。方法：利用计算机检索Cochrane图书馆(2013年第3期)、PubMed数据库、相关期刊论文、万方数据库、超星medalink,中文科技期刊全文数据库、中国生物医学文献数据库(均从建库截至2013年11月),纳入有关超声造影对乳腺良恶性肿块的临床研究文献。根据QUADAS条目评价纳入文献质量,用Meta-DiScl.4软件对其敏感性(SEN)、特异性(SPE)、阳性似然比(+LR)、阴性似然比(-LR)、诊断比值比(DOR)进行合并分析,并进行异质性检验,拟合受试者工作特征曲线(SROC),计算曲线下面积,用Stata version11.0软件deeks法绘制漏斗图。结果：最终纳入19篇研究,包括1161例研究对象,Meta分析结果显示：特异性合并值为0.79[95%CI(0.75,0.82)]、敏感性合并值为0.86[95%CI(0.83,0.89)]、阳性似然比合并值为3.92[95%CI(2.77,5.56)]、阴性似然比合并值为0.18[95%CI(0.13,0.26)]、诊断比值比为25.86[95%CI(13.77,48.55)]、受试者工作特征曲线下面积(AUC)为0.9170。纳入文献稳定性较好,deeks漏斗图分析提示未见明显发表偏倚(P=0.61)。结论：现有研究证实,超声造影对乳腺肿块良恶性鉴别诊断有较高的敏感性(86%)和较高的特异性(79%),乳腺恶性肿瘤组试验阳性的比值是乳腺良性肿瘤组试验阳性比值的25.86倍,说明诊断判别效果好,可作为乳腺良恶性肿瘤的鉴别诊断有效可行的方法。
[Abstract]:Objective: to evaluate the clinical value of contrast-enhanced ultrasonography (CEUs) in the diagnosis of breast benign and malignant tumors by Meta analysis. Methods: the Cochrane library (issue 3, 2013) was used to search the database of Cochrane, Chinese periodical full-text database, Wanfang database, superstar Medalink-based database, Chinese scientific and technological journal full-text database. The Chinese Biomedical Literature Database (all from the establishment of the database up to November 2013, including the clinical study of contrast-enhanced ultrasound for benign and malignant breast masses. According to the quality of literature included in the evaluation of QUADAS items, the sensitivity, specificity, positive likelihood ratio (LRN), negative likelihood ratio (NLR) and diagnostic ratio (DOR) were analyzed by Meta-DiScl.4 software, and the heterogeneity test was performed. The area under the curve was calculated by fitting the operating characteristic curve of the subjects, and the funnel diagram was drawn by Stata version11.0 software deeks method. Results: finally included in 19 studies, The results of meta-analysis of 1161 subjects showed that the specific combination value was 0.79 [95CI0.750.82], the sensitivity value was 0.86 [95CII 0.83N 0.89], the positive likelihood ratio was 3.92 [95CII 2.770.56], the negative likelihood ratio was 0.18 [95CII 0.130.26], the diagnostic ratio was 25.86 [95CI13.778.55], and the area under the operating characteristic curve was 0.9170. The results showed that there was no obvious publication bias (P0. 61). Conclusion: contrast-enhanced ultrasonography has high sensitivity and specificity in the differential diagnosis of benign and malignant breast masses. The ratio of test positive in breast malignant tumor group is 25.86 times of that in benign breast tumor group. It can be used as an effective and feasible method for differential diagnosis of breast benign and malignant tumors.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1;R737.9

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