J Cancer Res Clin Oncol DOI 10.1007/s00432-014-1728-x
Review – Clinical Oncology
Diagnostic accuracy of EUS and CT of vascular invasion in pancreatic cancer: a systematic review RenBao Yang · ManPeng Lu · XiaoXing Qian · Jiong Chen · Liang Li · JiaWen Wang · YouQian Zhang
Received: 29 May 2014 / Accepted: 30 May 2014 © Springer-Verlag Berlin Heidelberg 2014
Abstract Objective The objective of this study was to summarize the accuracy of preoperative vascular invasion with endoscopic ultrasound (EUS) and computed tomography (CT) test performance in pancreatic cancer with meta-analysis Method Two reviewers searched MEDLINE database to identify relevant studies. The reference lists of the trials were manually searched. Included studies used surgical and/or histological findings as the “gold standard,” and provided sufficient data to construct a diagnostic 2 × 2 table. A statistical program of Meta-Disc was used to calculate the pooled sensitivity, specificity, positive LR, negative LR, DOR, and the SROC curve. Publication bias was assessed by Deeks’ asymmetry test. Sensitivity analysis and subgroup analysis were calculated to down the heterogeneity. Meta-regression was calculated to evaluate potential sources of heterogeneity Result A total of 30 studies with 1,554 patients were included for the analysis, nine of these studies compared EUS with CT to assess the diagnostic efficiency The pooled sensitivity of EUS and CT was 72 % (95 % CI 67–77 %) and 63 % (95 % CI 58–67 %), and the pooled specificity of EUS and CT was 89 % (95 % CI 86–92 %)
Renbao Yang and ManPeng Lu have contributed equally to this work. R. Yang (*) · M. Lu · X. Qian · L. Li · J. Wang · Y. Zhang Department of General Surgery, Anhui Medical University Affiliated HeFei Hospital, Hefei Second People’s Hospital, Hefei 230011, China e-mail: [email protected] J. Chen Department of General Surgery, Affiliated Provincial Hospital of AnHui Medical University, Hefei 230011, China
and 92 % (95 % CI 90–94 %), respectively. The positive LR of EUS and CT was 5.14 (95 % CI 3.14–8.40) and 6.21 (95 % CI 3.96–9.71), and the negative LR was 0.36 (95 % CI 0.25–0.52) and 0.41 (95 % CI 0.31–0.55), respectively. The AUCs of EUS and CT were 0.9037 and 0.8948. The subgroup analysis of nine studies performed both EUS and CT showed CT scan with a lower sensitivity of 48 % (95 % CI 0.40–0.56), when compared to EUS of 69 % (95 % CI 0.61–0.77). The overall AUCs of CT scan appear to be lower (AUCs = 0.8589), compared with EUS (AUCs = 0.9379) Conclusion EUS performed better than CT in differentiating vascular invasion preoperative on pancreatic cancer. EUS could provide other additional information when compared with CT. Keywords Pancreatic cancer · Endoscopic ultrasound · Computed tomography · Vascular invasion · Meta-analysis
Introduction Pancreatic cancer was a virulent disease with a poor prognosis and a leading cause of cancer death worldwide (James and Gibbs 2005; Matsuda et al. 2008). Although recent advancement in surgical management and adjuvant treatment remained the potentially curative therapy, only about 10 % of pancreatic cancer could undergo curative surgery at the time of diagnosis, and overall, 1-year survival and 5-year survival were
Review – Clinical Oncology
Diagnostic accuracy of EUS and CT of vascular invasion in pancreatic cancer: a systematic review RenBao Yang · ManPeng Lu · XiaoXing Qian · Jiong Chen · Liang Li · JiaWen Wang · YouQian Zhang
Received: 29 May 2014 / Accepted: 30 May 2014 © Springer-Verlag Berlin Heidelberg 2014
Abstract Objective The objective of this study was to summarize the accuracy of preoperative vascular invasion with endoscopic ultrasound (EUS) and computed tomography (CT) test performance in pancreatic cancer with meta-analysis Method Two reviewers searched MEDLINE database to identify relevant studies. The reference lists of the trials were manually searched. Included studies used surgical and/or histological findings as the “gold standard,” and provided sufficient data to construct a diagnostic 2 × 2 table. A statistical program of Meta-Disc was used to calculate the pooled sensitivity, specificity, positive LR, negative LR, DOR, and the SROC curve. Publication bias was assessed by Deeks’ asymmetry test. Sensitivity analysis and subgroup analysis were calculated to down the heterogeneity. Meta-regression was calculated to evaluate potential sources of heterogeneity Result A total of 30 studies with 1,554 patients were included for the analysis, nine of these studies compared EUS with CT to assess the diagnostic efficiency The pooled sensitivity of EUS and CT was 72 % (95 % CI 67–77 %) and 63 % (95 % CI 58–67 %), and the pooled specificity of EUS and CT was 89 % (95 % CI 86–92 %)
Renbao Yang and ManPeng Lu have contributed equally to this work. R. Yang (*) · M. Lu · X. Qian · L. Li · J. Wang · Y. Zhang Department of General Surgery, Anhui Medical University Affiliated HeFei Hospital, Hefei Second People’s Hospital, Hefei 230011, China e-mail: [email protected] J. Chen Department of General Surgery, Affiliated Provincial Hospital of AnHui Medical University, Hefei 230011, China
and 92 % (95 % CI 90–94 %), respectively. The positive LR of EUS and CT was 5.14 (95 % CI 3.14–8.40) and 6.21 (95 % CI 3.96–9.71), and the negative LR was 0.36 (95 % CI 0.25–0.52) and 0.41 (95 % CI 0.31–0.55), respectively. The AUCs of EUS and CT were 0.9037 and 0.8948. The subgroup analysis of nine studies performed both EUS and CT showed CT scan with a lower sensitivity of 48 % (95 % CI 0.40–0.56), when compared to EUS of 69 % (95 % CI 0.61–0.77). The overall AUCs of CT scan appear to be lower (AUCs = 0.8589), compared with EUS (AUCs = 0.9379) Conclusion EUS performed better than CT in differentiating vascular invasion preoperative on pancreatic cancer. EUS could provide other additional information when compared with CT. Keywords Pancreatic cancer · Endoscopic ultrasound · Computed tomography · Vascular invasion · Meta-analysis
Introduction Pancreatic cancer was a virulent disease with a poor prognosis and a leading cause of cancer death worldwide (James and Gibbs 2005; Matsuda et al. 2008). Although recent advancement in surgical management and adjuvant treatment remained the potentially curative therapy, only about 10 % of pancreatic cancer could undergo curative surgery at the time of diagnosis, and overall, 1-year survival and 5-year survival were
