| Background: We aimed to systematic evaluate the diagnostic value of hysteroscopy and transvaginal ultrasonography for endometrial hyperplasia patients.Methods: A systematic search was performed using Pub Med,Medline,China Knowledge Network Database,Wanfang Chinese Database,China Biomedical Literature Database,China Science and Technology Journal Database,web of science,and The Cochrane Library from their dates of inception to October 30,2019,hysteroscopy and transvaginal ultrasonography were used for the diagnosis of endometrial lesions in those studies.Two researchers screened the literature,extracted data,and evaluated the methodological quality of the included studies independently based on the inclusion criteria.Results: a total of 1354 cases were incorporate into analysis from 9 diagnostic studies Meta-analysis showed that the diagnostic accuracy of hysteroscopy for endometrial hyperplasia lesions were : combined sensitivity=0.73[95%CI(0.68-0.77)],combined specificity=0.92[95 % CI(0.90-0.93)],combined negative likelihood ratio=0.34[95 % CI(0.22-0.52)],combined positive likelihood ratio=9.87[95 %CI(4.08-23.84)],combined diagnostic odds ratio=31.64[95%CI(10.34-96.78)],area under the summary receiver operating characteristic curve=0.8830.The combined sensitivity of transvaginal ultrasonography for those lesions were 0.69[95 %CI(0.64-0.74)],combined specificity was 0.78[95%CI(0.76-0.81)],combined negative likelihood ratio was 0.41[95%CI(0.34-0.50)],combined negative likelihood ratio was 3.40[95%CI(2.46-4.70)],combined diagnostic odds ratio was 8.94[95%CI(5.80-13.79)],and area under the summary receiver operating characteristic curve was 0.8180.Conclusions: Compared with transvaginal ultrasonography,hysteroscopy have higher sensitivity,specificity,and area under the summary receiver operating characteristic curve for the diagnose of endometrial hyperplasia,hysteroscopy should be selected priority as the auxiliary diagnosis. |
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