目的采用Meta分析评价CEUS诊断前列腺癌的临床价值。方法检索和筛选英文和中文数据库中2012年10月以前文献进行数据提取和质量评价,对敏感度、特异度、似然比(LR)、诊断比值比(DOR)、汇总受试者工作特征(SROC)曲线进行拟合分析,获得SROC曲线下面积(AUC),评价发表偏倚。结果纳入18篇文献(2714例患者),研究采用多种造影剂和成像模式,得出不同结果;合并敏感度、特异度、阳性LR、阴性LR和DOR分别为0.71、0.74、2.91、0.33和9.97,异质性的差异有统计学意义(P〈0.01);AUC为0.84;Begg(P=0.85)和Egger检验(P=0.14)显示不存在显著的发表偏倚。结论 CEUS是诊断前列腺癌的有效方法,但不能取代前列腺系统穿刺活检;需要通过高质量、前瞻性研究制定相对规范和统一的CEUS操作方法、造影剂使用和诊断标准。
Objective To observe the diagnostic value of CEUS for prostate cancer(PCa) with meta-analysis.Methods Original articles published up to October 2012 in English and Chinese databases were searched and screened.Characteristics of the included studies were recorded,and methodological qualities were assessed.Pooled weighted estimates of sensitivity,specificity,likelihood ratio(LR) and diagnostic odds ratio(DOR) were calculated.A summary receiver operator characteristic(SROC) curve was constructed to calculate the area under the curve(AUC).Publication bias analysis was also performed.Results Eighteen studies(2714 patients) were included.Various contrast agents and imaging modes were applied.There were variation in diagnostic values among the articles.The summary estimates of sensitivity,specificity,positive LR,negative LR and DOR were 0.71,0.74,2.91,0.33 and 9.97,respectively(P0.01).Value for AUC was 0.84.Begg's test(P=0.85) and Egger's test(P=0.14) did not show evidence of publication bias.Conclusion CEUS is a promising tool in the detection of PCa,but it cannot completely replace systematic biopsy under the present circumstances.It is necessary to standardize imaging techniques,contrast agents and diagnostic criteria by high-quality prospective trials.