摘要 目的系统性分析光敏剂介导的荧光膀胱镜(FC)与普通白光膀胱镜(WLC)在膀胱癌诊断与治疗中的临床价值。方法检索PubMed、Web of Science(SCI)、Embase、Cochrane Library、CNKI和万方数据库自2000年1月1日至2019年12月31日期间发表的光敏剂介导FC与WLC诊断和治疗膀胱癌的文献。由两位研究者独立检索文献,依据纳入文献标准进行筛选,应用QUADAS-2偏倚风险评价条目进行文献质量评价,提取并计算研究数据,采用Stata14软件按照随机效应模型进行meta分析。结果共纳入10篇文献,包含1218例患者、6591个组织样本。FC对膀胱癌诊断的合并灵敏度、合并特异度、合并阳性似然比、合并阴性似然比、合并诊断比值比及曲线下面积(AUC)分别为0.93(95%CI:0.87,0.97)、0.76(95%CI:0.56,0.76)、2.8(95%CI:2.2,3.7)、0.1(95%CI:0.06,0.17)、28(95%CI:17,46)、0.88(95%CI:0.85,0.91)。WLC对膀胱癌诊断的合并灵敏度、合并特异度、合并阳性似然比、合并阴性似然比、合并诊断比值比及AUC分别为0.66(95%CI:0.54,0.77)、0.82(95%CI:0.69,0.90)、3.7(95%CI:2.2,6.2)、0.41(95%CI:0.31,0.55)、9(95%CI:5,17)、0.80(95%CI:0.76,0.83)。FC和WLC诊断的灵敏度和特异度均有较高异质性(I2均>50%,P均<0.05)。Deek’s漏斗图提示FC组研究不存在发表偏倚(P>0.05),WLC组研究存在发表偏倚(P<0.05)。结论FC对膀胱癌的诊断敏感性高于WLC,但是其特异性比WLC低,同时使用FC和WLC可提高对膀胱癌的诊断率。 Objective The clinical value of photosensitizer-mediated fluorescent cystoscopy(FC)and white light cystoscopy(WLC)in the diagnosis and treatment of bladder cancer was systematically analyzed.Methods A systematic review was conducted on PubMed,Web of Science(SCI),Embase,Cochrane Library,CNKI,and Wan Fang Data databases for the diagnosis and treatment of bladder cancer by photosensitizer-mediated FC and WLC from January 1,2000 to December 31,2019.Two researchers independently searched the literature and screened it according to the criteria for inclusion.QUADAS-2 bias risk assessment items were used to evaluate the quality of the literature,extract and calculate research data.Stata14 software was used for meta-analysis according to the random effects model.Results A total of 10 studies were included,including 1218 patients and 6591 tissue samples.FC in the diagnosis of bladder cancer of pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnosis odds ratio and AUC were respectively:0.93(95%CI:0.87,0.97),0.76(95%CI:0.56,0.76),2.8(95%CI:2.2,3.7),0.1(95%CI:0.06,0.17),28(95%CI:17,46),0.88(95%CI:0.85,0.91),respectively.WLC in the diagnosis of bladder cancer of the pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnosis odds ratio and AUC were respectively:0.66(95%CI:0.54,0.77),0.82(95%CI:0.69,0.90),3.7(95%CI:2.2,6.2),0.41(95%CI:0.31,0.55),9(95%CI:5,17),0.80(95%CI:0.76,0.83).The sensitivity and specificity of the diagnosis of FC and WLC showed high heterogeneity(I>50%,P<0.05).Deek's funnel plot indicated that there was no publication bias in the FC group(P>0.05).There was publication bias in the WLC group(P<0.05).Conclusions The sensitivity of FC to the diagnosis of bladder cancer is higher than that of WLC,but its specificity is lower than that of WLC.Combined FC and WLC can improve the diagnosis of bladder cancer.
出处 《现代泌尿生殖肿瘤杂志》 2020年第5期276-282,共7页 Journal of Contemporary Urologic and Reproductive Oncology
关键词 荧光膀胱镜 普通白光膀胱镜 膀胱癌 诊断 meta分析 Fluorescence cystoscopy White light cystoscopy Bladder cancer Diagnosis meta-analysis
分类号 R73 [医药卫生—肿瘤]
