Subjective assessment versus ultrasound models to diagnose ovarian cancer: A systematic review and meta-analysis

被引：195

作者：

Meys, E. M. J. ^{[1
]}

Kaijser, J. ^{[2
,3
,7
]}

Kruitwagen, R. F. P. M. ^{[1
]}

Slangen, B. F. M. ^{[1
]}

Van Calster, B. ^{[4
]}

Aertgeerts, B. ^{[5
]}

Verbakel, J. Y. ^{[5
,6
]}

Timmerman, D. ^{[2
,3
]}

Van Gorp, T. ^{[1
]}

机构：

[1] MUMC, Dept Obstet & Gynaecol, GROW Sch Oncol & Dev Biol, P Debyelaan 25, NL-6202 AZ Maastricht, Netherlands

[2] Univ Hosp KU Leuven, Dept Obstet & Gynaecol, Herestr 49, B-3000 Leuven, Belgium

[3] Univ Hosp KU Leuven, Leuven Canc Inst, Herestr 49, B-3000 Leuven, Belgium

[4] Katholieke Univ Leuven, Dept Dev & Regenerat, Herestr 49, B-3000 Leuven, Belgium

[5] Katholieke Univ Leuven, Dept Gen Practice, Kapucijnenvoer 33, B-3000 Leuven, Belgium

[6] Univ Oxford, Nuffield Dept Primary Care Hlth Sci, Woodstock Rd, Oxford OX2 6GG, England

[7] Montessoriweg 1, NL-3083 AN Rotterdam, Netherlands

来源：

EUROPEAN JOURNAL OF CANCER | 2016年 / 58卷

关键词：

Ovarian neoplasms; Ovarian cancer; Ultrasonography; Sensitivity and specificity; Systematic review; Meta-analysis; MALIGNANT ADNEXAL MASSES; IOTA SIMPLE RULES; 3-DIMENSIONAL POWER DOPPLER; PROSPECTIVE CROSS-VALIDATION; LOGISTIC-REGRESSION MODELS; EVALUATE PELVIC MASSES; TUMOR-ANALYSIS-GROUP; EXTERNAL VALIDATION; PREOPERATIVE EVALUATION; DIFFERENTIAL-DIAGNOSIS;

D O I：

10.1016/j.ejca.2016.01.007

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Introduction: Many national guidelines concerning the management of ovarian cancer currently advocate the risk of malignancy index (RMI) to characterise ovarian pathology. However, other methods, such as subjective assessment, International Ovarian Tumour Analysis (IOTA) simple ultrasound-based rules (simple rules) and IOTA logistic regression model 2 (LR2) seem to be superior to the RMI. Our objective was to compare the diagnostic accuracy of subjective assessment, simple rules, LR2 and RMI for differentiating benign from malignant adnexal masses prior to surgery. Materials and methods: MEDLINE, EMBASE and CENTRAL were searched (January 1990 -August 2015). Eligibility criteria were prospective diagnostic studies designed to preoperatively predict ovarian cancer in women with an adnexal mass. Results: We analysed 47 articles, enrolling 19,674 adnexal tumours; 13,953 (70.9%) benign and 5721 (29.1%) malignant. Subjective assessment by experts performed best with a pooled sensitivity of 0.93 (95% confidence interval [CI] 0.92-0.95) and specificity of 0.89 (95% CI 0.86 -0.92). Simple rules (classifying inconclusives as malignant) (sensitivity 0.93 [95% CI 0.91 -0.95] and specificity 0.80 [95% CI 0.77-0.82]) and LR2 (sensitivity 0.93 [95% CI 0.89 -0.95] and specificity 0.84 [95% CI 0.78-0.89]) outperformed RMI (sensitivity 0.75 [95% CI 0.72-0.79], specificity 0.92 [95% CI 0.88-0.94]). A two-step strategy using simple rules, when inconclusive added by subjective assessment, matched test performance of subjective assessment by expert examiners (sensitivity 0.91 [95% CI 0.89-0.93] and specificity 0.91 [95% CI 0.87-0.94]). Conclusions: A two-step strategy of simple rules with subjective assessment for inconclusive tumours yielded best results and matched test performance of expert ultrasound examiners. The LR2 model can be used as an alternative if an expert is not available. (C) 2016 Elsevier Ltd. All rights reserved.

引用

页码：17 / 29

页数：13

共 84 条

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