Clinical examination versus magnetic resonance imaging in the pretreatment staging of cervical carcinoma: systematic review and meta-analysis
Clinical examination versus magnetic resonance imaging in the pretreatment staging of cervical carcinoma: systematic review and meta-analysis
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DOI：
10.1007/s00330-013-2783-4
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发表时间：
2013-07-01
影响因子：
5.9
通讯作者：
Hunink, Myriam G.
中科院分区：
文献类型：
--
作者：
Thomeer, Maarten G.;Gerestein, Cees;Hunink, Myriam G.
为了解临床检查和磁共振成像(MRI)在检测子宫颈癌宫旁侵犯和晚期疾病(FIGO分期为千分之几日元IIB)中的诊断性能，应用MEDLINE、EMBASE和Cochrane数据库检索相关研究报告。两名观察员报告了与使用QUADAS评分系统的分析和方法质量有关的数据。使用Deek漏斗图分析发表偏倚。协变量被添加到模型中，以研究临床检查和磁共振成像的技术和方法方面对汇总结果的影响。总共纳入了3,254名患者。部分验证偏差是经常遇到的。临床检查对宫旁侵犯的综合敏感性为40%(95%CI 25~58)，MRI为84%(95%CI 76~90)，晚期疾病临床检查为53%(95%CI 41~66)，MRI为79%(95%CI-)。临床检查和核磁共振检查的合并特异度是相似的。MRI的不同技术方面对总结结果有影响。在排除宫颈癌患者宫旁侵犯和进展期疾病方面，MRI明显优于临床检查。对于宫颈癌的分期，欧洲中心MRI比临床检查具有更高的敏感性。欧洲中心临床检查和MRI对宫颈癌的分期具有较高的特异度。欧洲中心临床检查的质量低于MRI研究。欧洲中心MRI技术的使用对总结结果有正向影响。
To review the literature on the diagnostic performance of clinical examination and magnetic resonance imaging (MRI) in detecting parametrial invasion and advanced stage disease (FIGO stage a parts per thousand yen IIB) in patients with cervical carcinoma.Reports of studies were searched using the MEDLINE, EMBASE and Cochrane databases. Two observers reported on data relevant for analysis and methodological quality using the QUADAS scoring system. Publication bias was analysed using Deeks funnel plots. Covariates were added to the model to study the influence on the summary results of the technical and methodological aspects of the clinical examination and MRI.In total, 3,254 patients were included. Partial verification bias was often encountered. Pooled sensitivity was 40 % (95 % CI 25-58) for the evaluation of parametrial invasion with clinical examination and 84 % (95 % CI 76-90) with MRI, 53 % (95 % CI 41-66) for the evaluation of advanced disease with clinical examination, and 79 % (95 % CI 64-89) with MRI. Pooled specificities were comparable between clinical examination and MRI. Different technical aspects of MRI influenced the summary results.MRI is significantly better than clinical examination in ruling out parametrial invasion and advanced disease in patients with cervical carcinoma.aEuro cent MRI has a higher sensitivity than clinical examination for staging cervical carcinoma.aEuro cent Clinical examination and MRI have comparably high specificity for staging cervical carcinoma.aEuro cent Quality of clinical examination studies was lower than that of MRI studies.aEuro cent The use of newer MRI techniques positively influences the summary results.aEuro cent Anaesthesia during clinical examination positively influences the summary results.