Diagnositc Performance Of NBI Magnifying Endoscopy In Early Gastric Cancer:A Meta-analysis

Objective:The Meta analysis method was used to evaluate the diagnostic value and clinical applicability of narrow band imaging magnifying endoscopy(NBI-ME)in early gastric cancer,which may provide a rapid and accurate diagnosis method and thus provided an effective basis for the treatment of early gastric cancer.Methods:The literature on the diagnostic value of NBI magnifying endoscopy for early gastric cancer was obtained by computer and manual search,and the literature was screened according to pre-set inclusion and exclusion criteria.The quality of the inclusion literature was evaluated according to the QUADAS-2 tool.We use METADISC 1.4 software and STATA 12.0 software to check the heterogeneity and calculate the combined sensitivity,specificity,positive likelihood ratio,negative likelihood ratio and diagnostic ratio.The forest map and Summary receiver operating character curve(SROC)was drawn and then calculate the area under the curve(AUC).Deek' s funnel mapping was used to evaluate the publication bias caused by the results of the study.For the heterogeneity of each study,we try to explore the source of heterogeneity by Meta regression analysis and the corresponding subgroup analysis was made according to the results.The clinical applicability of NBI magnification endoscopy in the diagnosis of early gastric cancer was evaluated by Fagan and likelihood ratio dot plot analysis.Results:In this Meta analysis,a total of 966 articles were retrieved and finally 28 articles were included,containing 7181 patients.The result of Meta-analysis showed that the combination sensitivity of NBI magnifying endoscopy in the diagnosis of early gastric cancer was 0.88,95%CI(0.83,0.91).The specificity is 0.95,95%CI(0.92,0.97).The positive likelihood ratio was 17.2,95%CI(11.26,26.27).The negative likelihood ratio value was 0.13,95%CI(0.09,0.18)The ratio of the combined diagnosis was 135.36,95%CI(78.81-232.48).The area under the curve(AUC)of SROC is 0.97,95%CI(0.95-0.98).Meta regression analysis suggests that the possible source of heterogeneity is nationality,number of lesions and the gross types of lesions.The result of Fagan analysis showed that the pretest probability was 50%,and the posterior probability reached 95%.The likelihood ratio of dot imaging showed that the combined effect of diagnosis lies in the upper right quadrant.Both showed that NBI magnifying endoscopy is a good diagnostic method for early gastric cancer.Deek 's Funnel diagram suggests that there may be publication bias in this study.Conclusion:1.NBI magnifying endoscopy has high sensitivity and specificity in the diagnosis of early gastric cancer.2.NBI magnifying endoscopy has a good clinical value in the diagnosis and screening of early gastric cancer and can be recommended as an auxiliary tool for clinical diagnosis and screening of early gastric cancer.