| Staging accuracy of esophageal cancer by endoscopic ultrasound: a meta-analysis and systematic review. | |
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MedLine Citation:
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PMID: 18330935 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: To evaluate the accuracy of endoscopic ultrasound (EUS) in the staging of esophageal cancer. METHODS: Only EUS studies confirmed by surgery were selected. Articles were searched in Medline and Pubmed. Two reviewers independently searched and extracted data. Meta-analysis of the accuracy of EUS was analyzed by calculating pooled estimates of sensitivity, specificity, likelihood ratios, and diagnostic odds ratio. Pooling was conducted by both the Mantel-Haenszel method (fixed effects model) and DerSimonian Laird method (random effects model). The heterogeneity of studies was tested using Cochran's Q test based upon inverse variance weights. RESULTS: Forty-nine studies (n = 2558) which met the inclusion criteria were included in this analysis. Pooled sensitivity and specificity of EUS to diagnose T1 was 81.6% (95% CI: 77.8-84.9) and 99.4% (95% CI: 99.0-99.7), respectively. To diagnose T4, EUS had a pooled sensitivity of 92.4% (95% CI: 89.2-95.0) and specificity of 97.4% (95% CI: 96.6-98.0). With Fine Needle Aspiration (FNA), sensitivity of EUS to diagnose N stage improved from 84.7% (95% CI: 82.9-86.4) to 96.7% (95% CI: 92.4-98.9). The P value for the c2 test of heterogeneity for all pooled estimates was > 0.10. CONCLUSION: EUS has excellent sensitivity and specificity in accurately diagnosing the TN stage of esophageal cancer. EUS performs better with advanced (T4) than early (T1) disease. FNA substantially improves the sensitivity and specificity of EUS in evaluating N stage disease. EUS should be strongly considered for staging esophageal cancer. |
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Authors:
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Srinivas-R Puli; Jyotsna-Bk Reddy; Matthew-L Bechtold; Daphne Antillon; Jamal-A Ibdah; Mainor-R Antillon |
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Publication Detail:
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Type: Journal Article; Meta-Analysis; Review |
Journal Detail:
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Title: World journal of gastroenterology : WJG Volume: 14 ISSN: 1007-9327 ISO Abbreviation: World J. Gastroenterol. Publication Date: 2008 Mar |
Date Detail:
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Created Date: 2008-03-11 Completed Date: 2008-07-30 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 100883448 Medline TA: World J Gastroenterol Country: China |
Other Details:
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Languages: eng Pagination: 1479-90 Citation Subset: IM |
Affiliation:
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Division of Gastroenterology, M580a Health Science Center, One Hospital Drive, M580a, Columbia, Missouri 65212, United States. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Endosonography* Esophageal Neoplasms / pathology*, ultrasonography* Humans Neoplasm Staging / methods* Publication Bias Sensitivity and Specificity |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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