尿液前列腺癌基因3检测诊断前列腺癌的Meta分析

Role of Urien Prostate Cancer Gene 3 Assay for the Diagnosis of Prostate Cancer:A Meta Analysis

目的采用Meta分析的方法评价尿液前列腺癌基因3(PCA3)检测在前列腺癌诊断中的应用价值。方法通过计算机检索PubMed(1966年1月—2010年10月)、Cochrane Library(2010年第3期)、中国学术期刊全文数据库(CNKI,1994年3月—2010年10月),收集公开发表的关于尿液PCA3检测用于前列腺癌诊断的队列研究或病例对照研究。应用Meta-disc 1.4和STATA 11.0统计软件进行分析,评价尿液PCA3检测诊断前列腺癌的敏感度、特异度、阳性似然比、阴性似然比和受试者工作特征(ROC)曲线下面积。结果共纳入11项研究,2 694例受试者。Meta分析结果显示,尿液PCA3检测诊断前列腺癌的敏感度和特异度分别为61%〔95%CI(58%,64%)〕和72%〔95%CI(70%,74%)〕,阳性似然比、阴性似然比分别为2.23〔95%CI(1.88,2.66)〕和0.54〔95%CI(0.46,0.62)〕;ROC曲线下面积为0.73〔95%CI(0.69,0.77)〕。结论尿液PCA3检测诊断前列腺癌的敏感度和特异度尚可,且有检测方便、无创等优点,可作为临床上无创诊断前列腺癌的有效方法。

Objective To evaluate the role of urine prostate cancer gene 3 （ PCA3 ） assay in the diagnosis of prostate cancer. Methods By searching literature published in PubMed （from January 1966 to October 2010）, Cochrane Library （ Sec- tion 3, 2010）, CNKI （ March 1994 to October 2010）, we collect the relevant cohort or case control studies on urine PCA3 as- say for the diagnosis of prostate cancer. The aggregated sensitivity, specificity, positive likelihood ratio, negative likelihood ra- tio, and area under the received operative curve （AUC） were calculated using Meta - disc 1.4 and STATA 11.0 statistic soft- ware. Results A total of 11 studies including 2 694 subjects were included in this Meta - analysis. The pooled sensitivity, spe- cificity, positive likelihood ratio, negative likelihood ratio, and AUC were 61% C95% CI （58%, 64% ） ], 72% C95% CI （70%, 74%）1, 2.23 [95%CI （1.88, 2.66）1, 0.54 [95%CI （0.46, 0.62）1, and0.73 [95%CI （0.69, 0.77）1, respectively. Conclusion Urine PCA3 assay has acceptable sensitivity and specificity and can be a used as a non - invasive tool for the diagnosis of prostate cancer.