【摘要】 目的:系统评价电子计算机断层扫描(Computed tomography,CT)诊断甲状腺癌颈部淋巴结转移的临床价值。方法:计算机检索PubMed、Cochrane协作网、CNKI和万方数据库,搜集关于CT诊断甲状腺癌颈部淋巴结转移的前瞻性诊断性试验,检索时限从建库至2019年8月。由2位研究者独立筛选文献、提取资料和评价偏倚风险后,采用Stata 15软件进行统计分析,计算其合并敏感度、特异度、阳性似然比、阴性似然比、诊断比值比(DOR)及其95%可信区间。结果:共纳入4项研究,包括565例患者。Meta分析结果显示:CT诊断甲状腺癌淋巴结转移的合并敏感度(Sensitivity)为0.48[95%(0.14,0.84)]、特异度(Specificity)为0.79[95%(0.72,0.84)]、阳性似然比(LR+)为2.3[95%(1.1,4.5)]、阴性似然比(LR-)为0.66[95%(0.30,1.42)]、诊断比值比(DOR)为3[95%(1,15)];AUC为0.78[95%(0.74,0.81)]。结论:CT诊断甲状腺癌颈部淋巴结具有重要的临床价值,可用于颈部淋巴结转移的分期诊断。更多还原

【Abstract】 Objective:To evaluate the clinical value of Computed Tomography(CT) in the diagnosis of cervical lymph node metastasis of thyroid cancer.Methods:The PubMed,Cochrane Collaboration,CNKI and Wanfang databases were searched for prospective diagnostic trials for the diagnosis of cervical lymph nodesmetastasis in thyroid cancer by CT.The search time was from the establishment of the library to August 2019.After two independent researchers screened the literature,extracted the data and assessed the risk of bias,statistical analysis was performed using Stata 15 software to calculate the combined sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,and diagnostic odds ratio(DOR) with their 95% confidence interval.Results:Four studies were included,including 565 patients.Meta-analysis showed that the combined sensitivity of CT for diagnosis of lymph node metastasis of thyroid cancer was 0.48[95%(0.14, 0.84)],specificity was 0.79[95%(0.72, 0.84)],positive likelihood ratio(LR+) was 2.3[95%(1.1, 4.5)],the negative likelihood ratio(LR-) was 0.66[95%(0.30, 1.42)],and the diagnostic odds ratio(DOR) was 3[95%(1, 15)];AUC was 0.78[95%(0.74, 0.81)].Conclusion:CT has important clinical value in diagnosis of cervical lymph nodes in thyroid cancer and can be used for staging diagnosis of cervical lymph node metastasis.更多还原