荧光原位杂交(FISH)技术对尿路上皮癌诊断价值的Meta分析

Detection of Urothelial Cancer by FISH Test:A Meta-Analysis

目的对国内已发表的应用荧光原位杂交(FISH)技术对尿路上皮癌患者的临床试验进行综合评价,对FISH技术与传统尿脱落细胞学检查进行比较,评价其对尿路上皮癌的诊断价值方法检索相关文献,根据纳入标准筛选文献,利用Meta-DiSc软件分别计算FISH检测组和尿脱落细胞学检查组敏感性、特异性、似然比和诊断性比数比,绘制总受试者工作特征(SROC)曲线,计算曲线下面积,并比较。结果有8篇文献被纳入,FISH检测尿路上皮癌的总敏感性为0.83(95%CI 0.79～0.86),特异性为0.90(95%CI 0.85～0.93),SROC曲线下面积为0.9278。尿脱落细胞学检查的总敏感性为0.51(95%CI0.47～0.56),特异性为0.93(95%CI 0.90～0.96),SROC曲线下面积为0.8501。FISH检查在总体诊断效能上较尿脱落细胞学检查更高,且具有统计学意义(P<0.05)。结论就本次Meta分析的结果而言,可以认为FISH检测较尿脱落细胞学检查在尿路上皮癌的诊断中具有更高的价值。

Objective To compare the diagnostic value of fluorescence in situ hybridization(FISH)and traditional urine exfoliative cytology in detection of urothelial cancer.Methods Literatures about diagnosis urothelial cancer with FISH and urine exfoliative cytology from January 2001 to December 2010 were retrieved and the effects were quantitatively estimated by meta-analysis.Results Eight trials were included.The pooled sensitivity and specificity of FISH test were 0.83(95%CI 0.79～0.86)and 0.90(95%CI 0.85～0.93),respectively. The pooled sensitivity and specificity of cytology were 0.51(95%CI 0.47～0.56)and 0.93(95%CI 0.90～0.96).respectively.The AUC for FISH and cytology were 0.9278 and 0.8501,respectively.The difference of AUG between the two tests was statistically significant(P<0.05).Conclusions From this Meta-analysis,FISH test is proved to have better diagnostic value in detection of urothelial cancer.