Gastric ultrasonic contrast for the diagnosis of infiltration depth in gastric carcinoma: A comprehensive meta-analysis

Abstract

As one of the more widely recognized forms of complementary and alternative medicine in the world, traditional Chinese medicine (TCM) has proven effective in the prevention and treatment of the transition “from gastritis to gastric cancer” according to its theories. Early identification of gastric carcinoma (GC) and precise evaluation of infiltration depth in GC before the surgery is crucial for determining the appropriate surgical approach and improving patient prognosis. Gastric filling ultrasonography (GFUS) has become a cost-effective, non-intrusive clinical option to evaluate tumor infiltration depth. It provides robust support for the prevention and treatment of the “from gastritis to gastric cancer” transition in TCM, ensuring the efficacy of TCM while effectively reducing the possibility of delayed GC treatment. This study aimed to assess the effect of GFUS for the diagnosis of infiltration depth in gastric carcinoma. From January 2000 to June 2024, a thorough literature search was carried out in 9 common Chinese and English databases. Include the literature that reported on the effect of GFUS on diagnosis T staging in gastric cancer, included at least 40 patients, and used histopathology as the reference standard. Data extracted included sensitivity, specificity, and diagnostic odds ratios (DORs). Meta-analyses were performed applying the bivariate random-effects (RE) method. Nineteen literature were finally included, comprising 2574 patients. The sensitivity (sen) and specificity (spe) of GFUS for T1 were 0.640 (0.574–0.703) and 0.973 (0.963–0.981). For T2, sen was 0.686 (0.634–0.734) and spe was 0.906 (0.888–0.922). T3 staging sen and spe were 0.795 (0.760–0.827) and 0.849 (0.825–0.872), while T4 staging sen and spe were 0.833 (0.791–0.870) and 0.943 (0.928–0.956). The summary receiver operating curve (sROC) demonstrated, the area under the curve (AUC) for T1, T2, T3, T4 were 0.9779, 0.8392, 0.8938, 0.9517, underscoring the diagnostic utility of GFUS. This meta-analysis highlights the high evaluating effect of GFUS for infiltration depth in GC, particularly for advanced T stages (T3 and T4). GFUS offers a reliable, non-invasive diagnostic alternative, especially valuable in resource-limited settings. Future research should focus on standardizing ultrasonographic techniques and integrating GFUS with other diagnostic modalities to enhance its clinical utility.