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目的探讨用循证医学Meta分析的方法,评估扩散加权成像(DWI)表观扩散系数(ADC)值用于评价乳腺癌新辅助化疗疗效的准确性。方法通过检索Embase、Pubmed、Cochrane图书馆、其他英文数据库及四大中文数据库中的相关文献,搜集符合纳入标准的原始文献进行质量评价、异质性检验、Meta回归分析及亚组分析,并选择相应的效应合并模型进行Meta分析,汇总敏感度(Se)、特异度(Sp)、阳性似然比(+LR)、阴性似然比(-LR)、诊断比值比(DOR)及汇总受试者工作特征曲线(SROC)。结果共纳入13篇英文文献,汇总DWI-ADC值评估乳腺癌新辅助化疗疗效的Se、Sp、+LR、-LR、DOR及SROC曲线下面积(AUC)分别为0.89(0.85~0.92)、0.71(0.66~0.76)、3.12(2.41~4.04)、0.20(0.13~0.29)、21.34(11.36~40.10)、0.88。结论 DWI-ADC值变化率在早期预测乳腺癌新辅助化疗疗效中具有重要意义。
OBJECTIVE: To evaluate the accuracy of diffusion-weighted imaging (DWI) for assessing the efficacy of neoadjuvant chemotherapy in breast cancer by evidence-based meta-analysis of Meta-analysis. Methods We searched the original literature of Embase, Pubmed, Cochrane Library, other English databases and four Chinese databases for quality evaluation, heterogeneity test, Meta-regression analysis and subgroup analysis, and selected The corresponding effect combination models were analyzed by Meta-analysis, and the results were summarized as Se, Sp, Positive LR, -LR, DOR, Job Performance Curve (SROC). Results A total of 13 English articles were included in this study. The areas under the curve of Se, Sp, + LR, -LR, DOR and SROC for evaluating the efficacy of neoadjuvant chemotherapy for breast cancer with DWI-ADC were 0.89 (0.85-0.92) and 0.71 (0.66-0.76), 3.12 (2.41-4.04), 0.20 (0.13-0.29), 21.34 (11.36-40.10), 0.88. Conclusion The rate of change of DWI-ADC value is of great significance in the early prediction of the efficacy of neoadjuvant chemotherapy for breast cancer.