中国甲状腺癌超声检测的系统回顾和荟萃分析

IF 0.4 4区 医学
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The analysis only considered original articles from China reporting the use of C-TIRADS and ACR-TIRADS confirmed by histology and FNA. Results: This review analyzed 26 studies with a total of 23,064 thyroid nodules from 19,114 patients to compare the diagnostic performance of C-TIRADS and ACR-TIRADS in predicting malignancy risk in thyroid nodules. Although the malignancy rates in each risk category were similar between the two systems, the TIRADS showed better diagnostic performance than C-TIRADS in terms of pooled specificity (95.0 % vs. 66.8 % of C-TIRADS). However, the pooled analysis showed that C-TIRADS had a better pooled sensitivity (94.6 % vs. 76.5% of ACR-TIRADS). The diagnostic odds ratio was 1.37 (95 % CI: 0.75-2.51) for ACR-TIRADS and 0.89 (95 % CI: 0.36-2.16) for C-TIRADS. Conclusion: Based on the results, both C-TIRADS and ACR-TIRADS are effective in predicting the risk of malignancy in thyroid nodules with similar overall diagnostic accuracy. 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引用次数: 0

摘要

背景:使用超声诊断甲状腺结节的一个主要缺点是其区分良性和恶性结节的能力有限。在中国,诊断甲状腺结节的风险分层和指导细针穿刺(FNA)的常用方法是中国甲状腺影像报告和数据系统(C-TIRADS)和美国放射学会甲状腺影像报告和数据系统(ACR-TIRADS)。 目的:本综述旨在评估 C-TIRADS 和 ACR-TIRADS 在准确识别中国甲状腺癌疑似患者恶性肿瘤风险方面的有效性。 研究方法从2018年1月至2022年12月,在PubMed、Google Scholar、Medline、Embase、Web of Science、Cochrane和中国国家知识基础设施(CNKI)数据库中进行了详细检索。分析仅考虑了中国的原创文章,这些文章报告了经组织学和 FNA 证实的 C-TIRADS 和 ACR-TIRADS 的使用情况。 结果:本综述分析了26项研究,共计19114名患者的23064个甲状腺结节,比较了C-TIRADS和ACR-TIRADS在预测甲状腺结节恶性风险方面的诊断性能。虽然两种系统在每个风险类别中的恶性肿瘤发生率相似,但就集合特异性而言,TIRADS的诊断性能优于C-TIRADS(C-TIRADS为95.0%,TIRADS为66.8%)。然而,汇总分析表明,C-TIRADS 的汇总灵敏度更高(94.6% 对 ACR-TIRADS 的 76.5%)。ACR-TIRADS 的诊断几率比为 1.37(95 % CI:0.75-2.51),C-TIRADS 为 0.89(95 % CI:0.36-2.16)。 结论根据研究结果,C-TIRADS 和 ACR-TIRADS 都能有效预测甲状腺结节的恶性风险,总体诊断准确性相似。这两种系统的结合可提高可疑或不确定病例的准确性。训练有素的放射科医生的长期经验很容易帮助得出诊断结论。由于没有任何一种系统或系统组合能对甲状腺结节的恶性程度做出 100% 的准确预测,因此最终的诊断结果有赖于经验丰富的放射科医生和医疗团队的总结评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Systematic Review and Meta-analysis on Ultrasound Detection of Thyroid Cancer in China
Background: One major drawback of using ultrasound for diagnosing thyroid nodules is its limited ability to distinguish between benign and malignant nodules. In China, the common methods for risk stratification and guiding fine needle aspiration (FNA) in diagnosing thyroid nodules are the Chinese Thyroid Imaging Reports and Data Systems (C-TIRADS) and American College of Radiology-Thyroid Imaging Reporting and Data System (ACR-TIRADS). Objectives: This review seeks to assess the effectiveness of C-TIRADS and ACR-TIRADS in accurately identifying the risk of malignancy in Chinese patients suspected of thyroid cancer. Methods: A detailed search was conducted in PubMed, Google Scholar, Medline, Embase, Web of Science, Cochrane, and China National Knowledge Infrastructure (CNKI) databases from January 2018 to December 2022. The analysis only considered original articles from China reporting the use of C-TIRADS and ACR-TIRADS confirmed by histology and FNA. Results: This review analyzed 26 studies with a total of 23,064 thyroid nodules from 19,114 patients to compare the diagnostic performance of C-TIRADS and ACR-TIRADS in predicting malignancy risk in thyroid nodules. Although the malignancy rates in each risk category were similar between the two systems, the TIRADS showed better diagnostic performance than C-TIRADS in terms of pooled specificity (95.0 % vs. 66.8 % of C-TIRADS). However, the pooled analysis showed that C-TIRADS had a better pooled sensitivity (94.6 % vs. 76.5% of ACR-TIRADS). The diagnostic odds ratio was 1.37 (95 % CI: 0.75-2.51) for ACR-TIRADS and 0.89 (95 % CI: 0.36-2.16) for C-TIRADS. Conclusion: Based on the results, both C-TIRADS and ACR-TIRADS are effective in predicting the risk of malignancy in thyroid nodules with similar overall diagnostic accuracy. The combination of both systems can be beneficial in enhancing accuracy in suspicious or uncertain cases. The long-term experience of the trained radiologists can readily help in concluding the diagnosis. As no single system or combination of systems can provide a 100% accurate prediction of the malignancy of thyroid nodules, the ultimate diagnosis relies on the concluding assessment of experienced radiologists and the medical team.
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来源期刊
Iranian Red Crescent Medical Journal
Iranian Red Crescent Medical Journal 医学-医学:内科
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期刊介绍: The IRANIAN RED CRESCENT MEDICAL JOURNAL is an international, English language, peer-reviewed journal dealing with general Medicine and Surgery, Disaster Medicine and Health Policy. It is an official Journal of the Iranian Hospital Dubai and is published monthly. The Iranian Red Crescent Medical Journal aims at publishing the high quality materials, both clinical and scientific, on all aspects of Medicine and Surgery
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