Diagnostic Performance Of Narrow Band Imaging In Early Laryngeal And Nasopharyngeal Carcinoma:A Systematic Review And Meta-analysis

Objectective:To provide a quick and accurate method in the diagnosis of early laryngeal and nasopharyngeal carcinoma,we collected related studies at home and abroad systematically,and evaluate the performance of narrow band imaging(NBI)for the diagnosis of laryngeal and nasopharyngeal cancer in a way of Meta-analysis.Methods:This Meta-analysis is performing under the guide of Cochrane protocol for Dianostic Accuracy and Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA).Firstly,searching the PubMed?Embase(Ovid)?The Cochrane Library?CNKI and CBM systematically.Then collecting related diagnostic studies of NBI in early laryngeal and nasopharyngeal carcinoma.The date is up to January 31 st,2016.Secondly,extracted the data of true positive?false positive?false negative and true negative based on the included and excluded criterion.The updated Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess study quality.Lastly,data analyses were performed using Meta-Disc 1.4 and Stata 12.0 software.Results:Eleven studies were included in this meta-analysis,including six studies of laryngeal cancer and five studies of nasopharyngeal carcinoma,which contained 716 and 615 numbers of patient,respectively.The result of this Meta-analysis were as followed:(1)The NBI diagnosis of laryngeal cancer: The evaluation of heterogeneity was calculated and gave an I2 of 65.0%.The pooled sensitivity was 0.94(95% CI: 0.91-0.96),specificity was 0.89(95% CI: 0.85-0.92),positive likelihood ratio(PLR)was 10.98(95%CI: 4.29-28.14),negative likelihood ratio(NLR)was 0.08(95% CI: 0.05-0.14),diagnostic odds ratio(DOR)was 142.12(95% CI: 46.42-435.15),and the area under Symmetric receiver operator characteristic curve(SROC)was 0.97.No marked publication bias(P = 0.84)was detected in this meta-analysis.(2)The NBI diagnosis of nasopharyngeal carcinoma: The evaluation of heterogeneity was calculated and gave an I2 of 51.8%.The pooled sensitivity was 0.81(95% CI: 0.54-0.94),specificity was 0.95(95% CI: 0.90-0.97),PLR was 15.38(95% CI: 8.21-28.81),NLR was 0.20(95% CI: 0.07-0.57),DOR was 93.82(95% CI: 29.65-296.88),and the area under the Hierarchical summary receiver operating characteristic curve(HSROC)was 0.96.No marked publication bias(P = 0.59)was detected in this meta-analysis.Conclusion:(1)The sensitivity and specificity of NBI in laryngeal cancer is high,the practical value is relatively good,and can be recommeded to use as an affiliated diagnostic tool in clinic.(2)The specificity of NBI in nasopharyngeal carcinoma is high,but its sensitivity and practical value in nasopharyngeal carcinoma needs to be improved.