EUS elastography for the differentiation of benign and malignant lymph nodes: a meta-analysis - 26/10/11
, 1, Jian Shi, MD , 1, Xin Zeng, MD , 1, Xiang Li, MD 1, Wei-Fen Xie, MD 1, Jia Guo, MD 2, ⁎, Yong Lin, MD 1, ⁎Reprint requests: Yong Lin, MD, Shanghai Changzheng Hospital, Second Military Medical University, Department of Gastroenterology, Fengyang 415, Shanghai, 200003 ChinaJia Guo, MD, Department of Ultrasonography, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, 225 Changhai Rd, Shanghai, ChinaRésumé |
Background |
EUS elastography is a new technique for differentiating benign and malignant lymph nodes (LNs) by describing the mechanical property of the target tissue.
Objective |
To assess the accuracy of EUS elastography by pooling data of existing trials.
Design |
Seven studies involving 368 patients with 431 LNs were included. Meta-analysis was performed. Pooling was conducted in a fixed-effect model or a random-effect model.
Patients |
This study involved 368 patients.
Intervention |
EUS elastography.
Main Outcome Measurements |
Meta-analysis and meta-regression analysis.
Results |
The pooled sensitivity of EUS elastography for the differential diagnosis of benign and malignant LNs was 88% (95% confidence interval [CI] 0.83-0.92), and the specificity was 85% (95% CI, 0.79-0.89). The area under the curve under summary receiver operating characteristic (SROC) was 0.9456. The pooled positive likelihood ratio was 5.68 (95% CI, 2.86-11.28), and the negative likelihood ratio was 0.15 (95% CI, 0.10-0.21). The subgroup analysis by excluding the outliers provided a sensitivity of 85% (95% CI, 0.79-0.90) and a specificity of 91% (95% CI, 0.85-0.95) for the differential diagnosis of benign and malignant LNs. The area under the curve under SROC was 0.9421.
Limitations |
A small number of studies met inclusion criteria.
Conclusion |
EUS elastography is a promising, noninvasive method for differential diagnosis of malignant LNs and may prove to be a valuable supplemental method to EUS-guided FNA.
Le texte complet de cet article est disponible en PDF.Abbreviations : AUC, CI, EUS-FNA, LN, LR, QUADAS, SROC
Plan
| DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. This study was supported by the National Natural Science Foundation of China (Nos. 81070347, 30971346, and 81000167). |
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| See CME section; p. 1115. |
Vol 74 - N° 5
P. 1001-1009 - novembre 2011 Retour au numéro
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