窄带成像内镜对鼻咽癌诊断价值的Meta分析

发布时间：2018-04-18 07:19

本文选题：窄带成像 + 鼻咽癌　；参考：《中华肿瘤防治杂志》2016年23期

【摘要】：目的鼻咽癌是头颈部常见恶性肿瘤之一,由于其易于复发和早期转移,因此鼻咽癌的早期诊断是临床工作中亟待解决的问题。内镜检测技术一直是头颈恶性肿瘤的有效检查方法,但传统白光内镜技术难以检测早期粘膜下病变。窄带成像技术(narrow band imaging,NBI)是一种新型内镜显像技术,可以清晰显示早期癌变部位粘膜下的血管形态分布。本研究通过对比评价NBI内镜与传统白光内镜对鼻咽癌的诊断价值,为临床实践提供参考。方法计算机检索PubMed、Cochrane Library、Ovid、Web of Science和中国知网数据库,并手工检索相关期刊,全面收集NBI方法诊断鼻咽癌的诊断性试验,检索时间截止到2016-01-31。由两位研究员根据纳入和排除标准独立筛选文献,提取资料并按诊断性试验准确性质量评价工具(QUADAS-2)评价质量,采用Stata 12.0软件进行Meta分析。结果最终纳入5篇研究,包括804个研究对象。Meta分析结果显示,窄带成像内镜诊断鼻咽癌的合并灵敏度和特异度分别为0.84(95%CI为0.67~0.94)和0.94(95%CI为0.90~0.97),层次综合受试者工作特征曲线(hierarchical summary receive operating characteristic,HSROC)曲线下面积为0.95(95%CI为0.92~0.96)。普通白光内镜诊断鼻咽癌的灵敏度和特异度分别为0.68(95%CI为0.59~0.76)和0.92(95%CI为0.62~0.99)。结论 NBI相比普通白光内镜诊断鼻咽癌具有更高的诊断价值,可以作为临床诊断的辅助工具。
[Abstract]:Objective nasopharyngeal carcinoma (NPC) is one of the most common malignant tumors in head and neck.Endoscopy is always an effective method for detecting malignant tumors of head and neck, but traditional white light endoscopy is difficult to detect early submucosal lesions.Narrow band imaging (NBI) is a new type of endoscopic imaging technique, which can clearly display the distribution of blood vessels in early cancerous sites.The purpose of this study was to evaluate the diagnostic value of NBI endoscopy and traditional white light endoscopy in nasopharyngeal carcinoma (NPC).Methods We searched the online database of PubMedus Cochrane Library of Science and Chinese knowledge Web by hand and collected the diagnostic test of NBI method for diagnosis of nasopharyngeal carcinoma (NPC) by hand. The search time was up to 2016-01-31.According to the inclusion and exclusion criteria, two researchers independently sifted the literature, extracted the data and evaluated the quality according to the diagnostic test accuracy evaluation tool QUADAS-2. The Meta analysis was carried out with Stata 12.0 software.The results were included in 5 studies, including 804 subjects. Meta-analysis showed that,The combined sensitivity and specificity of narrow-band imaging endoscopy in the diagnosis of nasopharyngeal carcinoma were 0.670.94) and 0.90 ~ 0.97 (0.84(95%CI), respectively. The area under the hierarchical summary receive operating characteristic HSROCcurve was 0.92 ~ 0.96.The sensitivity and specificity of ordinary white light endoscopy in the diagnosis of nasopharyngeal carcinoma were 0.590.76 (0.68(95%CI = 0.590.76) and 0.62U 0.99g (0.92(95%CI), respectively.Conclusion NBI has higher diagnostic value than ordinary white light endoscopy in the diagnosis of nasopharyngeal carcinoma and can be used as an auxiliary tool for clinical diagnosis.
【作者单位】：江南大学附属第四人民医院耳鼻咽喉头颈外科;江南大学无锡医学院;
【分类号】：R739.63

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