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目的应用Meta分析方法探讨CT透视(CTF)引导下经皮肺穿刺活检(PTNB)对肺部磨玻璃样病变(GGO)的诊断价值。方法系统检索PUBMED、EMBASE、EBSCO、OVID外文数据库以及CNKI、CBM、VIP和万方中文数据库,查找所有关于CTF引导下PTNB诊断肺部GGO的相关文献。数据分析采用Meta-Disc 1.4和Stata12.0软件进行。结果纳入研究4篇(n=246)。汇总灵敏度、特异度、阳性似然比(+LR)、阴性似然比(-LR)、诊断比值比(DOR)及95%可信区间(95%CI)分别为0.91(0.86~0.95)、1.00(0.91~1.00)、18.64(4.83~71.93)、0.11(0.05~0.26)、153.17(30.78~762.33)。汇总受试者工作特性曲线(SROC)并计算曲线下面积(AUC)为0.98。结论对于肺部GGO的诊断,CTF引导下PTNB具有较高的灵敏度、特异度和准确率,可作为肺部的GGO重要临床诊断方法之一。
Objective To evaluate the diagnostic value of percutaneous pulmonary puncture biopsy (PTNB) guided by CT fluoroscopy (CTF) in the diagnosis of lung ground-glass disease (GGO) by Meta-analysis. Methods The databases of PUBMED, EMBASE, EBSCO, OVID, CNKI, CBM, VIP and Wanfang Chinese were searched systematically to find out all relevant literature about PTNB diagnosis of lung GGO by CTF. Data analysis was performed using Meta-Disc 1.4 and Stata 12.0 software. Results were included in the study 4 (n = 246). The combined sensitivity, specificity, positive LR, negative LR LRR, 95% confidence interval (95% CI) and diagnostic odds ratio (DOR) were 0.91 (0.86-0.95) 1.00 (0.91-1.00), 18.64 (4.83-71.93), 0.11 (0.05-0.26), 153.17 (30.78-762.33). The receiver operating characteristic curve (SROC) was aggregated and the area under the curve (AUC) was calculated as 0.98. Conclusion For the diagnosis of pulmonary GGO, PTNB has a higher sensitivity, specificity and accuracy under the guidance of CTF, which can be used as one of the important clinical diagnostic methods of GGO in the lung.