Diagnostic Value of Endorectal Ultrasound in Preoperative Assessment of Lymph Node Involvement in Colorectal Cancer: a Meta-analysis.
BACKGROUND
Nodal invasion by colorectal cancer is a critical determinant in estimating patient survival and in choosing appropriate preoperative treatment. The present meta-analysis was designed to evaluate the diagnostic value of endorectal ultrasound (EUS) in preoperative assessment of lymph node involvement in colorectal cancer.


METHODS
We systematically searched PubMed, Web of Science, Embase, and China National Knowledge Infrastructure (CNKI) databases for relevant studies published on or before December 10th, 2014. The sensitivity, specificity, likelihood ratios, diagnostic odds ratio (DOR) and area under the summary receiver operating characteristics curve (AUC) were assessed to estimate the diagnostic value of EUS. Subgroup analysis and meta-regression were performed to explore heterogeneity across studies.


RESULTS
Thirty-three studies covering 3,016 subjects were included. The pooled sensitivity and specificity were 0.69 (95%CI: 0.63-0.75) and 0.77 (95%CI: 0.73-0.82), respectively. The positive and negative likelihood ratios were 3.09 (95%CI: 2.52-3.78) and 0.39 (95%CI: 0.32-0.48), respectively. The DOR was 7.84 (95%CI: 5.56-11.08), and AUC was 0.80 (95%CI: 0.77-0.84).


CONCLUSIONS
This meta-analysis indicated that EUS has moderate diagnostic value in preoperative assessment of lymph node involvement in colorectal cancer. Further refinements in technology and diagnostic criteria are necessary to improve the diagnostic accuracy of EUS.
Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China E-mail : gaohongyu3613@hotmail.com.
Li
L
Li
Shi
S
Chen
Ke
K
Wang
Jiao
J
Huang
Li
L
Liu
Sheng
S
Wei
Hong-Yu
HY
Gao
D019540:Area Under Curve; D002277:Carcinoma / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D019160:Endosonography; D006801:Humans; D016013:Likelihood Functions; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis / Q000000981:diagnostic imaging*; D009367:Neoplasm Staging; D011300:Preoperative Care; D012372:ROC Curve; D012680:Sensitivity and Specificity