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A Meta-Analysis And Systematic Review Of Accuracy Of Endoscopic Ultrasound For N Staging Of Gastric Cancers

Authors Chen J, Zhou C, He M, Zhen Z, Wang J, Hu X

Received 4 January 2019

Accepted for publication 12 September 2019

Published 27 September 2019 Volume 2019:11 Pages 8755—8764


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Alexandra R. Fernandes

Jiafei Chen, Chaoyang Zhou, Min He, Zhiming Zhen, Jie Wang, Xiaofei Hu

Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, People’s Republic of China

Correspondence: Xiaofei Hu
Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, People’s Republic of China
Tel +86-23-6876-5419
Fax +86-23-6546-3026

Background: Endoscopic ultrasonography (EUS) is widely used as a staging modality for gastric cancer. However, the results of studies on the use of EUS for N staging in gastric cancer vary. This study aimed at studying the overall diagnostic accuracy of EUS for N staging of gastric cancer.
Methods: Published studies were identified through searching the MEDLINE, Web of Science, EMBASE, SpringerLink and ScienceDirect databases. A bivariate random effect model was used to estimate the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). A hierarchical summary receiver operating characteristic curves (HSROC) based on the pooled data was also computed.
Results: Fifty studies (5223 patients) were included in this analysis. The pooled sensitivity, specificity, PLR, NLR and DOR of EUS for N staging were 0.82 (95% CI 0.78 to 0.85), 0.68 (0.63 to 0.73), 2.6 (2.2 to 3.0), 0.27 (0.22 to 0.32), and 10 (8 to 12), respectively. The area under the HSROC was 0.83.
Conclusion: The EUS may provide a clinically useful tool to guide physicians in the N staging of gastric cancer. However, physicians must note that the EUS has a relatively low specificity.

Keywords: gastric cancer, N staging, endoscopic ultrasound, meta-analysis

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