首页膀胱肿瘤病因/危险因素证据详情

Maintenance versus non-maintenance intravesical Bacillus Calmette-Guerin instillation for non-muscle invasive bladder cancer: A systematic review and meta-analysis of randomized clinical trials

原文: 2018 年 发布于 Frontiers in Physiology 浏览量:135次

作者: Chen S. Zhang N. Shao J. Wang X.

归属分类: 膀胱肿瘤病因/危险因素证据

DOI: 10.1016/j.urology.2015.12.079

文献简介

PURPOSE: To review the diagnostic performance of ≥1.5-T MRI for local staging of bladder cancer. METHODS: MEDLINE and EMBASE were searched up to February 21, 2017. We included diagnostic accuracy studies published since 2000 that used ≥1.5-T MRI for local staging (≥T2 [muscle-invasive]) in patients with bladder cancer, using pathology as the reference standard. The methodological quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2. Sensitivity and specificity were pooled and plotted in a hierarchical summary receiver operating characteristics plot. Sensitivity analyses using several clinically relevant covariates were performed. RESULTS: 24 studies (1774 patients) were included. Pooled sensitivity was 0.92 (95% CI 0.88-0.95) with specificity of 0.87 (95% CI 0.78-0.93). Sensitivity analyses showed that sensitivity estimates were comparable and consistently high across all subgroups, but specificity estimates were variable. Studies using 3-T scanners had higher specificity (0.93 [95% CI 0.86-0.98]) than those using 1.5-T scanners (0.83 [95% CI 0.74-0.98]). Studies using multiparametric MRI (conventional+≥2 functional sequences) showed the highest accuracy with sensitivity and specificity of 0.94 (95% CI 0.89-1.00) and 0.95 (95% CI 0.89-0.98), respectively. CONCLUSIONS: MRI shows good diagnostic performance for predicting muscle-invasiveness of bladder cancer. Multiparametric 3-T MRI seems to improve both sensitivity and specificity.

热门文献