Diagnostic accuracy of gastric filling ultrasonography in preoperative invasion depth (T stage) of gastric cancer: Meta-analysis.

Objective: This study aimed to evaluate the diagnostic value of gastric filling ultrasonography in the preoperative invasion depth (T staging) of gastric cancer.

Methods: We systematically searched several online electronic databases including CNKI, Wanfang Medical Database, VIP, CBM, Pubmed, Embase, Cochrane Library, and Web of Science from January 2010 to December 2021, identifying the study about gastric filling ultrasonography for diagnostic of invasion depth of gastric cancer. Using bivariate mixed effect model to calculate the sensitivity (Sen), specificity (spe), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) with 95% confidence interval (CI). Draw the summary receiver operating characteristic (sROC) curve, likelihood ratio matrix and fagan diagram to evaluate the diagnostic value of gastric filling ultrasonography in the preoperative invasion depth of gastric cancer. Sen analysis and Publication bias tests were performed.

Results: This study obtained 21 literatures and the quality were good. The pooled Sen and spe of gastric filling ultrasonography was: T1: 0.63 (95% CI:0.51-0.73), 0.96 (95% CI:0.94-0.98); T2: 0.67 (95% CI:0.62-0.71), 0.90 (95% CI:0.88-0.93); T3: 0.79 (95% CI:0.75-0.82), 0.83 (95% CI:0.80-0.86); T4: 0.80 (95% CI:0.73-0.86), 0.96 (95% CI:0.94-0.97), respectively. In addition, the PLR and NLR of gastric filling ultrasonography was: T1: 16.74 (95% CI:9.98-28.09), 0.39 (95% CI:0.29-0.52); T2: 6.98 (95% CI:5.20-9.38), 0.36 (95% CI:0.31-0.42); T3: 4.65 (95% CI:3.78-5.73), 0.26 (95% CI:0.21-0.31); T4: 18.51 (95% CI:12.77-26.83), 0.20 (95% CI: 0.15-0.29), respectively. The DOR of gastric filling ultrasonography in T1-T4 was: 43.17 (95% CI:20.62-90.41),19.13 (95% CI:12.61-29.03), 18.15 (95% CI:12.86-25.62), 90.63 (95% CI:47.36-173.41), respectively. The sROC curve revealed that the area under the curve (AUC) of T1-T4 was: 0.93, 0.82, 0.87, 0.97, respectively. Sen analysis indicated that the study was steadily. And there is no publication bias in this study. But the study has some heterogeneity.

Conclusion: Gastric filling ultrasonography is useful for clinical preoperative T staging of gastric cancer, and the result indicate that the accuracy of gastric filling ultrasonography in discriminating T1-T4 is higher than that in discriminating T2 - T3. It can be used as an imaging diagnostic method for preoperative T staging of gastric cancer.