平行检测血清CA19-9和血浆K-ras突变对胰腺癌诊断价值的Meta分析

Diagnostic Value of Individual Versus Parallel Test of Serum CA19-9 and Circulating K-ras Mutation in Pancreatic Adenocarcinoma: A Meta-Analysis

目的评估平行检测血清CA19-9和血浆K-ras突变对胰腺癌诊断的价值。方法网络文献检索Pubmed、CNKI、维普等数据库,全面收集关于平行检测血清CA19-9和K-RAS基因突变对胰腺癌诊断研究的文献。采用Meta-Disk1.4、RevMan5和ComprehensiveMeta-AnalysisVersion2（CMA2）进行全面的Meta分析。结果按照预定的纳入标准,共纳入符合文献8篇。结果显示在胰腺癌的诊断中,平行检测血CA19-9和K-RAS基因突变的灵敏度和特异度分别是0.909（0.864-0.943）和0.711（0.618-0.792）。而单独检测血CA19-9和KRAS的灵敏度分别是0.719（0.656-0.776）和0.671（0.606-0.731）;其特异度分别是0.693（0.6-0.776）和0.912（0.845-0.957）。单独检测CA19-9和平行检测的敏感度和特异度优势比（OddsRatio,OR）分别是0.793（0.6-1.038）和0.986（0.653-1.488）。单独检测K-RAS和平行检测的敏感度和特异度优势比（OddsRatio,OR）分别是0.773（0.585-1.022）和1.305（0.880-1.936）。

Objective To compare the sensitivity and specificity between individual and parallel detection of circulating K-ras mutations and serum CA19-9 level in patients with pancreatic adenocarcinoma. Methods A systematic literature search was carried out in Pubmed, the Chinese National Knowledge Infrastructure （ CNKI ）, Wanfang, Weipu and Google Scholar through May 2014. This study focused on and analyzed individual and parallel detection of serum CA19-9 and circulating K-ras mutations, with Meta-Disk 1.4, RevMan 5 and Comprehensive Meta- Analysis Version 2 （ CMA2 ） . Result Finally, eight studies that met the inclusion criteria were analyzed. Heterogeneity was not found （ P 〉 0.05 ） . Sensitivity, specificity, odds ratio, diagnostic odds ratio for individual and parallel detection of serum CA19-9 and circulating K-ras mutations were summed up as follows： The pooled sensitivity and specificity for CA19-9 were 71.9% （ 95% CI： 65.6% to77.6% ） and 69.3% （ 95% CI： 60% to 77.6% ） ; for K-ras were 67.1% （ 95% CI： 60.6% to 73.1% ） and 91.2% （ 95% CI： 84.5% to 95.7% ） ; for parallel detection, the findings were 90.9% （ 95% CI： 86.4% to 94.3% ） and 71.1% （ 95% CI： 61.8% to 79.2% ） . The odds ratio of sensitivity and specificity that compares CA19-9 to parallel is 0.793 （ 95% CI： 0.6 to 1.038 ） and 0.986 （ 95% CI： 0.653 to 1.488 ） . The odds ratio of sensitivity and specificity that compares K-ras to parallel is 0.773 （ 95% CI： 0.585 to 1.022 ） and 1.305 （ 95% CI： 0.880 to 1.936 ） .