血清GP73与AFP对肝细胞癌诊断价值的Meta分析

Diagnostic value of serum GP73 and AFP in hepatocellular carcinoma:a meta-analysis

目的比较血清高尔基体蛋白73(GP73)与甲胎蛋白(AFP)对肝细胞癌(HCC)的诊断价值。方法检索TheCochrane Central Register of Controlled Trials、PubMed、EMBase、Web of Science、Nature、Science、Springer link、中国期刊全文数据库、中国科技期刊数据库(维普)、万方数字化期刊全文数据库2012年10月以前公开发表的中、英文文献,收集关于血清GP73以及AFP诊断HCC的相关文献,按照纳入与排除标准筛选文献并进行信息统计、科学性评估。采用Meta-Disc 1.4软件进行数据分析,通过汇总后的敏感度、特异度、似然比及受试者工作特征(ROC)曲线综合评价血清GP73与AFP对HCC的诊断价值。结果共纳入18篇文献,样本量为5279例,其中HCC 2075例,非HCC的对照组3204例。通过随机效应模型计算得出血清GP73和AFP的汇总敏感度分别为0.78(0.76～0.79)和0.55(0.53～0.57),汇总特异度分别为0.84(0.83～0.86)和0.80(0.78～0.81),汇总阳性似然比分别为5.60(4.05～7.74)和2.92(2.04～4.17),汇总阴性似然比分别为0.28(0.24～0.32)和0.58(0.51～0.67),ROC曲线下面积分别为0.8849及0.6827,Z检验显示其差异具有统计学意义(P<0.01)。结论血清GP73对HCC有较高的诊断价值,可作为替代血清AFP的重要参考指标。

Objective To evaluate the diagnostic value of serum Golgi protein 73（GP73） and alpha fetoprotein（AFP） in patients with hepatocellular carcinoma（HCC）.Methods The Cochrane Central Register of Controlled Trials,PubMed,EMBase,Web of Science,Nature,Science,Springer link,Chinese Journal Full-Text Database（CNKI）,Database for Chinese Technical Periodical（VIP）,Wanfang Digital Journal Full-text Database（before October 2012） were retrieved to collect relevant literature in which the diagnostic value of serum GP73 and AFP in patients with HCC was evaluated.The statistical information and scientific quality were assessed and classified.The data were analyzed using Meta-Disc 1.4 software.The diagnostic value of serum GP73 and AFP in HCC was evaluated by the statistical indicators as pooled sensitivity,pooled specificity,pooled likelihood ratio and summary receiver operating characteristic curve（ROC curve）.Results Eighteen articles were collected and 5279 cases were included in the study（2075 HCC and 3204 NHCC patients）.After heterogeneity test,the data were analyzed by random-effect model.The results showed that,the pooled sensitivity,specificity of the serum GP73 and AFP were 0.78（0.76-0.79） and 0.55（0.53-0.57）,0.84（0.830.86） and 0.80（0.78-0.81）,respectively.The pooled positive likelihood ratio and negative likelihood ratio was 5.60（4.05-7.74） and 2.92（2.04-4.17）,0.28（0.24-0.32） and 0.58（0.51-0.67）,respectively.The ROC area under the curve（AUC） was 0.8849 and 0.6827,and Z test showed that the difference was statistically significant（P0.01）.Conclusion The serum GP73 has a higher sensitivity and specificity than AFP in the diagnosis of HCC,and it can be regarded as one of the valuable reference tests in patients with HCC.