甲状腺球蛋白在甲状腺疾病中临床意义的系统评价

Diagnosis Value of Serum Thyroglobulin in Patients with Thyroid Diseases:A Systematic Review

目的:采用Meta分析的方法评价甲状腺球蛋白在甲状腺良性疾病和甲状腺癌中的临床意义。方法:通过检索MEDLINE、EMBASE、The Cochrane Library,中国生物医学文献数据库、中国学术期刊全文数据库和其他方式广泛收集文献。根据QUADAS质量评价标准评价纳入文献的质量,用Meta-Disc软件对其敏感度、特异度、阳性似然比、阴性似然比等进行合并分析,并进行异质性检验,绘制综合受试者工作特征曲线(summary receiver operatorcharacteristic curve,SROC)。结果:最终纳入5篇文献。合并敏感度0.60,合并特异度0.83,合并比值比2.68,SROC下面积(AUC)=0.6454。结论:现有研究证实:甲状腺球蛋白在甲状腺癌中的阳性率是甲状腺良性疾病中的2.68倍,有统计学差异,但敏感度不高。尚需更多设计严谨、科学的临床试验进一步证实。

Objective：To evaluate the quality of the current studies involving the value of serum thyroglobulin in the diagnosis of thyroid benign diseases and thyroid carcinoma.Methods：We comprehensive collected current studies about serum thyroglobulin in thyroid benign diseases and thyroid carcinoma by computer and manual searches.QUADAS items were used for quality assessment in our systematic review.Meta-disc software was used to analyze pooled sensitivity,pooled specificity,pooled positive likelihood ratio and pooled negative likelihood ratio,pooled diagnostic test odds ratio and heterogeneity test,and draw summary receiver operator characteristic curve（SROC）.Results：Totally 5 studies were included.To identify thyroid benign diseases and thyroid carcinoma,pooled sensitivity was 0.60.pooled specificity was 0.83,pooled odds ratio was 2.68,the area under curve（AUC） was 0.645 4.Conclusion：The results of statistic alanalysis showed that the positive rate of thyroglobulin in thyroid carcinoma is 2.68 times more than in benign thyroid diseases.There was significant difference.But sensitivity was not high and reporting quality of the studies was relatively poor.The conclusion still need more clinical trials to confirm.