超声与针吸细胞学检查对甲状腺结节诊断的Meta分析

摘要

目的 评价超声和针吸细胞学检查(FNAC)对甲状腺结节的诊断价值.方法 对Pubmed、Embase、中国知网、中国生物医学文献数据库(CBM)和维普数据库进行检索,根据诊断性试验研究纳入标准纳入和排除文献,采用QUADAS条目对纳入文献进行质量评价,应用Meta-Disc 1.4软件对纳入的研究结果进行Meta分析并绘制汇总受试者工作特征曲线(SROC曲线),计算曲线下面积.结果 共纳入10篇文献,甲状腺FNAC诊断共纳入3595例,超声诊断共纳入4694例,FNAC与超声诊断的敏感度分别0.88[95％CI(0.86～0.90)]和0.80[95％CI(0.76～0.83)];特异度分别为0.94[95％CI(0.93～0.95)]、0.87[95％CI(0.85～0.88)]；SROC曲线下面积分别为0.9504、0.8859.结论 甲状腺结节FNAC的准确性较超声高,但两者对甲状腺结节的诊断都具有重要的意义,使甲状腺疾病患者避免不必要的手术治疗,对临床具有重大的诊断价值.%Objective To evaluate the diagnostic value of the FNAC and ultrasound for thyroid nodule.Methods PubMed,EMbase,CNKI,CBM,VIP were searched to include articles according to the inclusion and exclusion criteria of diagnostic research.QUADAS was used to evaluate the quality of literature included,and Meta-Disc 1.4 software was used to do the Meta analysis,draw the summary receiver operating characteristic (SROC curve),and calculate the area under the curve.Results A total of 10 literatures involving 4694 cases with ultrasound diagnosis and 3595 cases with FNAN diagnosis were included.The sensitivity of ultrasound and FNAC was 0.88 (95％ CI 0.86-0.90) and 0.80(95％ CI 0.76-0.83) respectively;the specificity was 0.94 (95％ CI 0.93-0.95) and 0.87 (95％ CI 0.85-0.88) respectively ;and the area under SROC curve was 0.9504 and 0.8859 respectively.Conclusion The accuracy of FNAC is better than ultrasound in diagnosis of thyroid nodule,and both of them have great value in the diagnosis of thyroid nodule,which can make patients with thyroid disease avoid unnecessary surgical treatment,have significant diagnostic value.