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目的通过采用meta分析,对乳腺癌诊断中,钼靶X线和MRI两种影像学的方法进行诊断符合率的对比分析,为实际应用中乳腺癌诊断符合率提供参考。方法收集2011到2016年,国内发表的有关钼靶X线和MRI对乳腺癌诊断的相关文献,通过关键词检索和纳入排除标准对文献进行入组。采用Review Manager 5.3对纳入文献资料进行整理分析,对于文献间的异质性和偏移性,并通过两种meta分析模型对结果的敏感性进行对比,保证结果的可靠性。结果 1共检索到文献643篇文章,通过阅读全文入选31篇,最后入选26篇文献;2钼靶X线组和MRI组通过异质性检验,I~2=37%,Chi~2=38.33,P=0.03,采用的固定效应模型结果显示OR=0.35,95CI=(0.30~0.42),P<0.05;4合并后的诊断符合率为钼靶X线组为81.19%,MRI组为89.10%,MRI优于钼靶X线。5敏感性分析显示,采用随机效应模型后结果为OR=0.37,95CI=(0.31~0.43),P<0.05,两种方法差距不大所以结果可靠。结论本研究的得出MRI在乳腺癌影像学诊断中对于诊断符合率是要高于钼靶X线,从早发现的角度出发,MRI是提高诊断符合率的重要方法。
OBJECTIVE: To provide a reference for the coincidence rate of diagnosis of breast cancer by using meta-analysis in the diagnosis of breast cancer, mammography X-ray and MRI two methods of imaging diagnosis. Methods From 2011 to 2016, the related literatures about the diagnosis of breast cancer by mammography X-ray and MRI were collected in our country. The articles were collected through keyword search and inclusion exclusion criteria. Adopted Review Manager 5.3 to organize and analyze the included documents for the heterogeneity and offset between the documents, and to compare the sensitivity of the results by two meta-analysis models to ensure the reliability of the results. RESULTS: A total of 643 articles were retrieved and 31 articles were selected by reading the full text and 26 articles were finally selected. The heterogeneity of 2 mammographic X-ray and MRI groups showed that I ~ 2 = 37%, Chi ~ 2 = 38.33 , P = 0.03. The fixed effect model used showed OR = 0.35,95 CI = (0.30-0.42), P <0.05. 4 The coincidence rate of the combined diagnosis was 81.19% for the mammography X-ray group and 89.10% for the MRI group , MRI is superior to mammography X-ray. 5 Sensitivity analysis showed that the results of using the random effects model OR = 0.37,95 CI = (0.31 ~ 0.43), P <0.05, the difference between the two methods is not so the result is reliable. Conclusions This study concluded that the diagnostic accuracy of MRI in the diagnosis of breast cancer is higher than that of molybdenum target X-ray. From the point of view of early detection, MRI is an important method to improve the diagnostic accuracy.