标题：超声造影评估膀胱肿瘤TNM分期价值的系统评价

      作者：林莉 1，傅崇德 2，李涛 3    1.西安航天总医院超声科，陕西 西安 710000；2.西安航天总医院泌尿外科，陕西 西安 710000；3.西安交通大学第一附属医院长安区医院泌尿外科，陕西 西安 710000

      卷次： 2021年32卷9期

      【摘要】 目的 系统评价超声造影(CEUS)在膀胱肿瘤TNM分期中的诊断价值。方法 计算机检索PubMed、Cochrane Library、中国知网、维普、万方数据库及中国生物医学文献服务系统，检索时间均从建库至2020年7月，收集包含超声造影评估膀胱肿瘤TNM分期的文献，应用Meta-Disc 1.4软件进行诊断性分析，绘制 SROC曲线并计算面积。结果 共纳入11篇文献，共计940例患者；Meta分析结果显示，CEUS评估膀胱肿瘤TNM分期的合并敏感性为 0.95 (0.93~0.98)、合并特异性为 0.91 (0.87~0.94)、合并阳性似然比为 9.02(6.33~12.85)、合并阴性似然比 0.05(0.03~0.09)、合并诊断比值比为147.01 (73.48~294.12)；SROC曲线下面积AUC为0.985 4；CEUS的诊断符合率高于CT，差异有统计学意义(P=0.003)。结论 CEUS在术前膀胱肿瘤TNM分期的评估中具有较高的敏感性和特异性，值得临床推广应用。
      【关键词】 膀胱肿瘤；超声造影；TNM分期；系统评价
      【中图分类号】 R737.14 【文献标识码】 A 【文章编号】 1003—6350（2021）09—1207—06

Diagnostic performance of contrast-enhanced ultrasound in assessing the TNM staging of bladder tumor: asystematic review and meta-analysis.
LIN Li 1, FU Chong-de 2, LI Tao 3. 1. Department of Doppler Ultrasonic, Xi`anAerospace General Hospital, Xi'an 710000, Shaanxi, CHINA; 2. Department of Urology, Xi`an Aerospace General Hospital,Xi'an 710000, Shaanxi, CHINA; 3. Department of Urology, Chang'an District Hospital, the First Affiliated Hospital of Xi'anJiaotong University, Xi'an 710000, Shaanxi, CHINA
【Abstract】 Objective To systematic assess the diagnostic performance of contrast-enhanced ultrasound(CEUS) for evaluating the TNM staging of bladder tumor. Methods The literature on diagnosis trials of CEUS forTNM staging of bladder tumor was searched in electronic databases including PubMed, Cochrane Library, CNKI,VIP, Wanfang data and SinoMed up to July 2020. Meta-Disc 1.4 software was used for meta-analysis and SROC curve.Results A total of 11 trials were included, involving 940 cases. Results of meta-analysis of CEUS for TNM staging ofbladder tumor showed that the pooled sensitivity was 0.95 (0.93 to 0.98), the pooled specificity was 0.91 (0.87 to 0.94),the positive likelihood ratio was 9.02 (6.33 to 12.85), the negative likelihood ratio was 0.05(0.03 to 0.09), diagnosis oddsratio was 147.01 (73.48 to 294.12), and the AUC of SROC was 0.9854. Accurate diagnosis rate of CEUS was higherthan CT (P=0.003). Conclusion CEUS has a higher sensitivity and specificity in the diagnosis of bladder tumor TNMstaging. Therefore, CUES should be recommended to use in clinical practice.
      【Key words】 Bladder tumor; Contrast-enhanced ultrasound (CEUS); TNM staging; Systematic review·荟萃分析·doi:10.3969/j.issn.1003-6350.2021.09.030