Abstract
BACKGROUND: To investigate the diagnostic efficacy of sentinel lymph nodes (SLN) in breast cancer by percutaneous contrast-enhanced ultrasound (CEUS) through pooled analysis of relevant studies published before June 2021. METHODS: We conducted a systematic review and meta-analysis of relevant studies by searching the electronic databases of PubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang and VIP and the studies were screened according to their inclusion and exclusion criteria. Sensitivity (SEN), specificity (SPE), positive likelihood ratio (+LR), negative likelihood ratio (-LR) and diagnostic odds ratio (DOR) were calculated by Meta-disc 1.4 software and the summary receiver operating characteristic (SROC) curve and area under the curve of ROC (AUC) were constructed. RESULTS: Twenty-two publications evaluating the diagnostic efficacy of SLN in breast cancer under percutaneous CEUS were included in the meta-analysis. The diagnostic sensitivity, specificity were 0.86 (95% CI: 0.83-0.88) and 0.89 (95% CI: 0.87-0.91) for SLN in breast cancer detected by percutaneous CEUS respectively using a random effect model. The +LR and -LR were combined in a random effect model due to significant statistical heterogeneity (p < 0.05). The pooled +LR, -LR were 7.06 (95% CI: 4.34-11.50), and 0.17 (95% CI: 0.12-0.24), respectively. The combined DOR was 53.32 (95% CI: 29.74-95.61) for SLN diagnosis in breast cancer by percutaneous CEUS under a random effect model. The AUC was 0.94 which indicated that CEUS had high diagnostic efficacy of SLN in patients with breast cancer. CONCLUSIONS: CEUS is a noninvasive method for the detection SLN in patients of breast cancer with relative high prediction efficacy.