Meta-analysis Of Double Contrast-enhanced Ultrasonography In Diagnosis Of Preoperative T Staging Of Gastric Cancer

Objective:To evaluate the diagnostic value of double contrast-enhanced ultrasonography in the preoperative T staging of gastric cancer by meta-analysis.Methods:The computer searched all the relevant Chinese and English literatures of the diagnostic experimental studies on the preoperative staging of gastric cancer by double contrast-enhanced ultrasound in Chinese National Knowledge Infrastructure,Wanfang Database,VIP Database,PubMed,Cochrane Library,Embase and Web of Science,and the starting and ending time for searching the literatures is January2000 to January 2020.Literature was searched by the combination of subject words and free words,and the references included in the study were researched,and the literatures were screened according to the inclusion and exclusion criteria.The data of the four-cell table(true positive value,false positive value,false negative value,true negative value)of each document were directly or indirectly extracted,and Meta-disc 1.4 software was used to conduct statistical analysis to evaluate the heterogeneity and threshold effect among the studies.The heterogeneity sources were analyzed by meta-regression,and the pooled sensitivity(SEN),specificity(SPE),positive likelihood ratio(LR+)and negative likelihood ratio(LR+)of double contrast-enhanced ultrasonography in the diagnosis of gastric cancer at different stages were calculated.Finally,the stability of the study of sensitivity analysis and evaluation was evaluated.Results:A total of 562 Chinese and English literatures were retrieved,and 17 literatures were finally included.A total of 17 studies,including 15 Chinese literatures and 2English literatures,included a total of 2317 patients,including 1500 males and 817 females.The quality and clinical significance of all included literatures were better.Combined statistics of the value of double contrast-enhanced ultrasonography in preoperative T1 staging of gastric cancer: The pooled SEN was 0.805(95%confidence interval [CI]: 0754-0.849).The pooled SPE was 0.979(95% CI:0.972-0.985).The pooled LR-was 0.249(95%CI: 0.173-0.359).The pooled LR+was 37.577(95%CI: 18.928-74.602).The AUC was 0.9705.Combined statistics of the value of double contrast-enhanced ultrasonography in preoperative T2 staging of gastric cancer: The pooled SEN was 0.758(95%CI: 0.720-0.793).The pooled SPE was 0.916(95%CI: 0.902-0.929).The pooled LR-was 0.274(95%CI: 0.212-0.356).The pooled LR+ was 9.039(95%CI: 6.513-12.545).The AUC was 0.8925.Combined statistics of the value of double contrast-enhanced ultrasonography in preoperative T3 staging of gastric cancer: The pooled SEN was 0.845(95%CI:0.820-0.868).The pooled SPE was 0.867(95%CI: 0.849-0.884).The pooled LRwas 0.182(95%CI: 0.150-0.222).The pooled LR+ was 6.478(95%CI: 5.064-8.287).The AUC was 0.9283.Combined statistics of the value of double contrastenhanced ultrasonography in preoperative T4 staging of gastric cancer: The pooled SEN was 0.854(95%CI: 0.822-0.881).The pooled SPE was 0.968(95%CI: 0.958-0.976).The pooled LR-was 0.159(95%CI: 0.108-0.236).The pooled LR+ was23.987(95%CI: 18.528-31.055).The AUC was 0.9828.Conclusion:Double contrast-enhanced ultrasonography has high sensitivity and specificity in the preoperative diagnosis of T staging of gastric cancer,which is consistent with pathological staging,and can be used as a conventional imaging method to evaluate the depth of gastric cancer infiltration before surgery.