Meta-analysis: surveillance with ultrasound for early-stage hepatocellular carcinoma in patients with cirrhosis.
Meta-analysis: surveillance with ultrasound for early-stage hepatocellular carcinoma in patients with cirrhosis.
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DOI：
10.1111/j.1365-2036.2009.04014.x
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发表时间：
2009-07
影响因子：
7.6
通讯作者：
Marrero JA
中科院分区：
文献类型：
--
作者：
Singal A;Volk ML;Waljee A;Salgia R;Higgins P;Rogers MA;Marrero JA
大多数研究超声检测肝细胞癌（HCC）的准确性的研究并没有反映出该测试如何用于监测与诊断。确定超声监测检测HCC的性能特征，特别是米兰标准定义的早期HCC。使用MEDLINE和SCOPUS数据库进行的系统性文献综述产生了6项研究，这些研究评估了超声在任何阶段对HCC的准确性，13项研究针对早期HCC。监测超声在临床出现之前检测到了大多数肿瘤，合并灵敏度为94%。然而，超声检测早期HCC的敏感性为63%，效果较差。甲胎蛋白没有提供额外的好处超声。荟萃回归分析显示，与每年监测相比，每6个月超声检查对早期HCC的敏感性显著更高。目前的研究有局限性，如验证偏差和次优质量。超声监测显示对早期HCC的敏感性有限，尽管每隔6个月检测一次可能会有所改善。目前可用的证据评估监督超声有显着的局限性，未来的研究是必要的，以确定最佳的监测方法，早期肝癌。
A majority of studies investigating the accuracy of ultrasound for detecting hepatocellular carcinoma (HCC) do not reflect how this test is used for surveillance vs. diagnosis. To determine the performance characteristics of surveillance with ultrasound for the detection of HCC, particularly early HCC as defined by the Milan criteria. A systematic literature review using the MEDLINE and SCOPUS databases yielded six studies that evaluated the accuracy of ultrasound for HCC at any stage and 13 studies that were specific to early HCC. Surveillance ultrasound detected the majority of tumours before they presented clinically, with a pooled sensitivity of 94%. However, ultrasound was less effective for detecting early HCC with a sensitivity of 63%. Alpha-fetoprotein provided no additional benefit to ultrasound. Meta-regression analysis demonstrated a significantly higher sensitivity for early HCC with ultrasound every 6 months than with annual surveillance. Current studies have limitations such as verification bias and are of suboptimal quality. Surveillance with ultrasound demonstrates limited sensitivity for early HCC, although this may be improved by testing at 6-month intervals. Currently available evidence evaluating surveillance ultrasound has significant limitations and future studies are necessary to determine optimal surveillance methods for early HCC.
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影响因子：
9.8
作者：
Colli, A;Fraquelli, M;Duca, P
通讯作者：
Duca, P
影响因子：
29.4
作者：
Di Bisceglie, AM
通讯作者：
Di Bisceglie, AM
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2
作者：
Higgins, JPT;Thompson, SG
通讯作者：
Thompson, SG
影响因子：
105.7
作者：
Higgins, JPT;Thompson, SG;Altman, DG
通讯作者：
Altman, DG
影响因子：
13.5
作者：
Llovet, JM;Bustamante, J;Bruix, J
通讯作者：
Bruix, J