现场快速评估法对超声引导下甲状腺细针穿刺满意度影响的Meta分析

The Effect of Rapid Onsite Evaluation on the Satisfaction of Ultrasound-Guided Thyroid Fine Needle Aspiration: A Meta-Analysis

摘要: 背景：甲状腺细针穿刺(FNA)可在治疗前鉴别甲状腺结节的性质，但有效的标本取材是诊断的前提。快速现场评价(ROSE)提高细针穿刺标本满意度的有效性仍需进一步评估。目的：通过荟萃分析评估ROSE在超声引导下甲状腺FNA中的应用价值。方法：检索英文数据库PubMed，Embase和Web of Science以及中文数据库万方、维普和中国知网中评估开展ROSE对甲状腺结节细针穿刺的影响的相关文献，使用Review Maneger 5.4进行数据的分析。结果：本研究共纳入19项研究，包括25,991例甲状腺结节细针穿刺案例。12,074例(46.5%)甲状腺结节穿刺中进行了ROSE，13,917例(53.5%)未进行ROSE。荟萃分析显示ROSE可将FNA的标本满意度提升20% (RR 1.20, 95% CI [1.11, 1.30])。亚组分析显示：在基础FNA满意度 < 86%时，ROSE可将FNA的标本满意度提升27% (RR 1.27, 95% CI [1.17, 1.38])。但在基础FNA满意度 ≥ 86%时，ROSE仅将FNA的标本满意度提升提高了4% (RR 1.04, 95% CI [1.03, 1.06])。结论：ROSE可提高FNA标本满意度，尤其是对于基础FNA标本满意度较低的医疗机构。

Abstract: Background: Thyroid fine needle aspiration (FNA) can distinguish the nature of thyroid nodules before treatment, but effective specimen sampling is a prerequisite for diagnosis. The effectiveness of rapid onsite evaluation (ROSE) to improve the satisfaction of fine needle puncture specimens needs to be further evaluated. Objective: To evaluate the value of ROSE in ultrasound-guided thyroid FNA by meta-analysis. Methods: Literature related to the evaluation of the effect of ROSE on thyroid nodular fine needle puncture in English databases PubMed, Embase and Web of Science, as well as Chinese databases Wanfang, Weipu and CNKI were searched, and the data were analyzed using Review Maneger 5.4. Results: A total of 19 studies were included in this study, including 25,991 cases of fine needle puncture of thyroid nodules. ROSE was performed in 12,074 (46.5%) thyroid nodule puncture, and 13,917 (53.5%) did not. A meta-analysis showed that ROSE increased sample satisfaction with FNA by 20% (RR 1.20, 95% CI [1.11, 1.30]). Subgroup analysis showed that ROSE could increase FNA satisfaction by 27% (RR 1.27, 95% CI [1.17, 1.38]) when basic FNA satisfaction was < 86%. However, when the basic FNA satisfaction was ≥ 86%, ROSE only increased the FNA satisfaction by 4% (RR 1.04, 95% CI [1.03, 1.06]). Conclusion: ROSE can improve the satisfaction of FNA specimens, especially in medical institutions with low basic satisfaction of FNA specimens.