血清Pro-GRP对小细胞肺癌的诊断价值的Meta分析

Meta-analysis on the diagnostic value of serum Pro-GRP in small cell lung cancer

目的:探讨血清Pro-GRP(胃泌素释放肽前体)对SCLC(小细胞肺癌)诊断的价值。方法:计算机检索Medline数据库、Cochrane图书馆、OVID、Web of Science、CNKI、万方、维普等数据库,搜索并且收集涉及血清Pro-GRP对SCLC诊断的相关文献,采用QUADAS对文献的质量进行评价,采用Meta-Disc 1.4对数据进行分析。结果:按照统一的排除和纳入标准,得到符合要求的文献13篇,中文9篇,英文4篇。累计病例2587例,其中小细胞肺癌例855例,良性肺部疾病、健康、其他肿瘤共1732例。13个研究结果的汇总SEN和SPE分别为79%(76%-82%)和94%(92%-95%)。汇总+LR、-LR分别为:13.73(8.41-22.44)、0.24(0.20-0.30)。DOR为58.34(32.70-103.74),曲线下面积AUC为0.8628,Q为0.7935。结论:本研究证据显示,Pro-GRP诊断SCLC有一定的临床价值,可作为早期诊断SCLC的指标之一,但是由于纳入的研究不够多,样本量不够大,所以Pro-GRP诊断SCLC仍然需要大样本的研究加以进一步验证。

Objective：To evaluate the diagnostic value of serum Pro-GRP in small cell lung cancer（SCLC）.Methods：We searched Medline,Cochrane Library,OVID,Web of Science,CNKI and other databases by computer to gather the papers about the diagnostic value of serum Pro-GRP in small cell lung cancer.QUADAS was used to evaluate the quality of the included papers.The software of Metadisc 1.4 was used to conduct the Meta-analysis.Results：We selected 14 literatures with the unified inclusion and exclusion criteria,4 literatures are in English and the others Chinese.A total of 855 cases and 1732 controls were included.The result of Meta-analysis showed that the sensitivity and specificity are 79%（76%-82%） and 94%（92%-95%） respectively.Positive likelihood（＋LR） ratio and negative likelihood ratio（-LR） are 13.73（8.41-22.44）,0.24（0.20-0.30）respectively.The diagnostic odds ratio（DOR） is 58.34（32.70-103.74）.And the area under curve of SORC（AUC） is 0.8628,Q is 0.7935.Conclusion：Pro-GRP is a potential biomarker to diagnosis of small cell lung cancer according to our study.We can regard it as one of the diagnostic indicators.However more high quality,large size,multiple center studies are still required to further evaluate the value of Pro-GRP on the diagnosis of small cell lung cancer.