B超、CT、MRCP及ERCP诊断胆管癌临床价值的Meta分析

发布时间：2018-06-11 21:34

本文选题：胆管肿瘤 + 诊断　；参考：《重庆医学》2017年12期

【摘要】：目的系统评价B超、CT、磁共振胰胆管造影(MRCP)及经内镜逆行性胰胆管造影术(ERCP)诊断胆管癌的价值。方法收集PubMed、Medine、Embase、中国知网(CNKI)、万方5大电子文献数据库中所有关于胆管癌的文献,对B超、CT、MRCP及ERCP怀疑胆管癌的患者进行系统回顾,评价指标包括灵敏度及特异度,采用汇总受试者工作特征(SROC)曲线得出曲线下面积(AUC)及各自的Q值,分析4种检查方法的诊断价值。结果共纳入44篇文章,总病例数4 364例。B超、CT、MRCP合并灵敏度、特异度分别为0.75、0.72,0.82、0.80,0.85、0.87,ERCP细胞学及ERCP图像灵敏度、特异度分别为0.62、0.98,0.88、0.84),Q值分别为0.690 8、0.787 8、0.841 7(ERCP细胞学及ERCP图像分别为0.846 1、0.833 2)。结论 CT、MRCP及ERCP3者诊断胆管癌的准确性相当,均明显高于B超,是有效的辅助检查方法。ERCP细胞学检查合并特异度明显高于其他检查方法,对高度怀疑胆管恶性肿瘤者具有高度的临床诊断价值。
[Abstract]:Objective to systematically evaluate the value of B-ultrasound, CT, magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) for the diagnosis of cholangiocarcinoma. Methods all the literature on cholangiocarcinoma were collected from the 5 large electronic literature databases of PubMed, Medine, Embase, CNKI and Wanfang, and the patients with B-ultrasound, CT, MRCP and ERCP suspected of cholangiocarcinoma were carried out. The evaluation indexes included sensitivity and specificity. The diagnostic value of the 4 methods was analyzed by using the SROC curve to obtain the area (AUC) and their respective Q values. The results were included in 44 articles, the total number of cases was 4364 cases, B ultrasound, CT, MRCP sensitivity, and the specificity of 0.75,0.72,0.82,0.80,0.85,0.87 respectively. The sensitivity and specificity of ERCP cytology and ERCP images were 0.62,0.98,0.88,0.84, respectively, and Q values were 0.690 8,0.787 8,0.841 7 respectively (ERCP cytology and ERCP images were 0.846 1,0.833 2 respectively). Conclusion CT, MRCP and ERCP3 were accurate in the diagnosis of cholangiocarcinoma. The specificity is significantly higher than other examination methods, and has high clinical diagnostic value for patients with high suspicion of malignant tumor of bile duct.
【作者单位】：重庆医科大学附属第一医院消化内科;
【分类号】：R735.8

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