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目的:系统评价CT结肠镜用于结直肠肿瘤和息肉诊断的临床价值。方法:通过计算机检索及手工查阅,全面收集CT结肠镜用于结直肠肿瘤和息肉诊断的中英文文献,按纳入与排除标准筛选文献并提取纳入研究中有关准确度的数据,根据QUADAS条目进行质量评价,采用Me-ta Disc 1.4软件检验研究间的异质性并进行Meta分析。结果:最终纳入英文文献22篇,中文文献0篇。异质性检验结果为Spearman相关系数=0.406,P=0.244,提示阈值效应引起的异质性较小,但是存在其他因素导致的异质性,按随机效应模型进行Meta分析。CTC结肠镜诊断结直肠肿瘤和息肉的敏感度和特异度分别为69%和83%,而且诊断的敏感度和特异度随着肿物大小的增加而增加,分别为62%~81%和90.1%~92.4%。结论:用CT结肠镜诊断结直肠肿瘤和息肉具有很高的特异性,但其敏感度波动范围很大。
Objective: To evaluate the clinical value of CT colonoscopy in the diagnosis of colorectal tumors and polyps. METHODS: Chinese and English literature on CT colonography for the diagnosis of colorectal tumors and polyps were collected comprehensively by computerized search and manual review. The articles were screened by inclusion and exclusion criteria and the data included in the studies for accuracy were extracted. The quality was assessed according to the QUADAS entry Evaluations were performed using Me-ta Disc 1.4 software to examine heterogeneity among studies and perform meta-analysis. Results: 22 English papers and 0 Chinese papers were finally included. Heterogeneity test results Spearman correlation coefficient = 0.406, P = 0.244, suggesting that the threshold effect caused by heterogeneity is small, but there are other factors leading to heterogeneity, according to the random effects model for meta-analysis. The sensitivity and specificity of CTC colonoscopy in the diagnosis of colorectal tumors and polyps were 69% and 83%, respectively, and the diagnostic sensitivity and specificity increased with the size of the tumor, ranging from 62% to 81% and 90.1 % ~ 92.4%. CONCLUSIONS: The diagnosis of colorectal tumors and polyp with CT colonoscopy is highly specific, but its sensitivity varies greatly.