CAJ | 학술논문

目的：采用Meta分析方法评价超声弹性成像对甲状腺结节良恶性诊断的价值。方法计算机检索中国知网（CNKI）、万方数据库，收集所有使用超声弹性成像对甲状腺结节良恶性进行诊断的文献，根据Cochrane协作网与诊断试验方法组推荐的诊断试验纳入标准筛选文献，提取纳入研究的特征信息。采用新修订的诊断性试验准确性质量评价工具QUADAS-2对纳入的文献进行质量评价；Meta-DiSc 1.4软件进行Meta分析，并绘制受试者工作特征曲线（SROC）。结果根据检索词初步检索出文献231篇，经筛选最终纳入16篇，其中5篇文献质量评价为A级，8篇为B级，3篇为C级。16篇文献中包含甲状腺结节患者1325例，结节病灶1641个。合并诊断灵敏度和特异度分别为0.87[95%可信区间（CI）为0.84~0.89]、0.84（95%CI为0.82~0.86），合并阳性和阴性似然比分别为5.85（95%CI为4.47~7.65）、0.17（95%CI为0.13~0.21），SROC曲线下面积为0.93，标准误（SE）=0.01。结论超声弹性成像对甲状腺结节良恶性具有较高临床诊断价值。
목적：채용Meta분석방법평개초성탄성성상대갑상선결절량악성진단적개치。방법계산궤검색중국지망（CNKI）、만방수거고，수집소유사용초성탄성성상대갑상선결절량악성진행진단적문헌，근거Cochrane협작망여진단시험방법조추천적진단시험납입표준사선문헌，제취납입연구적특정신식。채용신수정적진단성시험준학성질량평개공구QUADAS-2대납입적문헌진행질량평개；Meta-DiSc 1.4연건진행Meta분석，병회제수시자공작특정곡선（SROC）。결과근거검색사초보검색출문헌231편，경사선최종납입16편，기중5편문헌질량평개위A급，8편위B급，3편위C급。16편문헌중포함갑상선결절환자1325례，결절병조1641개。합병진단령민도화특이도분별위0.87[95%가신구간（CI）위0.84~0.89]、0.84（95%CI위0.82~0.86），합병양성화음성사연비분별위5.85（95%CI위4.47~7.65）、0.17（95%CI위0.13~0.21），SROC곡선하면적위0.93，표준오（SE）=0.01。결론초성탄성성상대갑상선결절량악성구유교고림상진단개치。
Objective To evaluate the diagnostic value of ultrasonic elastography (UE) in benign and malignant thyroid nodules by Meta analysis. Methods Computer was used to search China national knowledge infrastructure(CNKI), Wanfang database, and relevant Chinese articles about UE in assessing diagnostic accuracy of benign and malignant thyroid nodules were collected. According to the diagnostic test criteria recommended by Cochrane Screening and Diagnostic Test Group, the literatures were screened and feature information was included in the study. The quality evaluation tool of diagnostic test accuracy(QUADAS-2) was used to assess the quality of the literatures; Meta analysis was performed with Meta-DiSc 1.4 software, and receiver operating characteristic curve(SROC) was drawn. Results According to the key words, two hundred and thirty-one articles were retrieved initially, and finally 16 articles were included after screening; the quality of five articles was grade A; eight was grade B; and three was grade C. Sixteen articles contained 1 325 patients with 1 641 thyroid nodules. The pooled sensitivity and specificity were 0.87 [95%confidence interval (CI): 0.84 - 0.89] and 0.84 (95%CI: 0.82 - 0.86), respectively; the pooled positive and negative likelihood ratios were 5.85 (95%CI:4.47-7.65) and 0.17(95%CI:0.13 - 0.21), respectively; the area under the curve of SROC was 0.93, standard error(SE) =0.01. Conclusion The results of meta-analysis suggest that UE has high value in the diagnosis of benign and malignant thyroid nodules.