采用 SROC 曲线法系统评价端粒酶检测筛查肺癌的效果

Systematic reviews in the telomerase activity testing for screening lung cancer by use of SROC curve method

目的：利用SROC曲线方法系统评价端粒酶在肺癌诊断中的临床意义。方法以“端粒酶”和“肺癌”为主题词，对近20年公开发表的学术期刊进行检索，纳入文献并收集数据，利用Meta-DiSc 1．4软件进行SROC分析。结果1．取样为组织标本的22篇文献，异质性比较大（P＝0．017），应用随机效应模型对数据分析，合并灵敏度和特异度分别是0．788（0．761～0．814）和0．955（0．936～0．969），SROC曲线下面积AUC为0．9515，SE（ AUC）＝0．0145；2．取样为灌洗液标本的10篇文献，不存在异质性（P＝0．633），应用固定效应模型对数据分析，合并灵敏度和特异度分别是0．777（0．734～0．816）和0．922（0．888～0．948），SROC曲线下面积AUC为0．9369，SE（AUC）＝0．0141。结论端粒酶是一种较理想的肿瘤标记物，尤其是肺泡灌洗液中端粒酶的活性检测用于辅助临床诊断具有较高的稳定性和准确度。

Objective To evaluate the clinical significance of telomerase in the diagnosis of lung cancerusing SROC curve method.Methods Looking“telomerase”and“lung cancer”as keywords,retrieving journalspublished within past 20 years in order to incorporate into literatures and to collect data .To conduct the SROC analysisusing Meta -DiSc 1.4 software.Results 1.Twenty -two documents were sampled as tissue specimensand the heterogeneity was relatively large （P =0.017）.To analyze the data with random effective models ,thecombined sensitivity and specificity were 0.788（0.761 -0.814）and 0.955（0.936 -0.969）,respectively.TheSROC AUC area under the curve was 0.9515,SE（AUC） =0.0145.2.There was no heterogeneity（P =0.633）amongthe 10 lavaged literatures.By use of fixed effects model for data analysis ,the combined sensitivity and specificitywere 0.777（0.734 -0.816） and 0.922（0.888 -0.948）,and SROC AUC area under the curve was0.9369,SE（AUC） =0.0141.Conclusion Telomerase is a ideal tumor marker,and the detection of telomeraseactivity in lavage fluid is stable and accurate in clinical diagnosis .