【摘要】 目的通过采用meta分析,对乳腺癌诊断中,钼靶X线和MRI两种影像学的方法进行诊断符合率的对比分析,为实际应用中乳腺癌诊断符合率提供参考。方法收集2011到2016年,国内发表的有关钼靶X线和MRI对乳腺癌诊断的相关文献,通过关键词检索和纳入排除标准对文献进行入组。采用Review Manager 5.3对纳入文献资料进行整理分析,对于文献间的异质性和偏移性,并通过两种meta分析模型对结果的敏感性进行对比,保证结果的可靠性。结果 1共检索到文献643篇文章,通过阅读全文入选31篇,最后入选26篇文献;2钼靶X线组和MRI组通过异质性检验,I~2=37%,Chi~2=38.33,P=0.03,采用的固定效应模型结果显示OR=0.35,95CI=(0.30~0.42),P<0.05;4合并后的诊断符合率为钼靶X线组为81.19%,MRI组为89.10%,MRI优于钼靶X线。5敏感性分析显示,采用随机效应模型后结果为OR=0.37,95CI=(0.31~0.43),P<0.05,两种方法差距不大所以结果可靠。结论本研究的得出MRI在乳腺癌影像学诊断中对于诊断符合率是要高于钼靶X线,从早发现的角度出发,MRI是提高诊断符合率的重要方法。更多还原

【Abstract】 Objective To compare and analyze the diagnostic accordance rates of molybdenum target X-ray and MRI in diagnosis of breast cancer through meta analysis,provide reference for practical application of breast cancer diagnosis. Methods The domestic relevant literatures about molybdenum target X-ray and MRI in diagnosis of breast cancer from 2011 to 2016 were collected,then the literatures were grouped according to key words,inclusion and exclusion criteria,Review Manager 5. 3 software was used to summarize and analyze the literatures,two kinds of meta analysis models were used to compare the sensitivity to ensure the reliability of the results targeting to the heterogeneity and migration of literatures. Results A total of 643 articles were searched,31 articles were selected by reading the full text,finally 26 literatures were selected; mammography group and MRI group passed heterogeneity test( I2= 37%,Chi2= 38. 33,P = 0. 03),the fixed effect model showed that OR = 0. 35,95 CI( 0. 30- 0. 42),P< 0. 05; the combined diagnostic accordance rate in mammography group and MRI group were 81. 19% and 89. 10%,respectively. The sensitivity analysis showed the results after random effect model: OR = 0. 37,95CI( 0. 31-0. 43),P<0. 05,the gap of the two methods was small,so the results were reliable. Conclusion The diagnostic accordance rate of MRI is higher than that of molybdenum target X-ray in diagnosis of breast cancer. MRI is an important method to improve the diagnostic accordance rate in the perspective of early detection.更多还原