血清a-L岩藻糖甘酶与血清甲胎蛋白联合检测对原发性肝癌诊断价值的Meta分析

Diagnostic Value of Serum a-L Fucose Gan Enzyme Combined with Serum Alpha-Fetoprotein for Primary Hepatic Carcinoma: A Meta-Analysis

目的系统评价血清a-L岩藻糖甘酶(AFU)与血清甲胎蛋白(AFP)联合检测对原发性肝癌的诊断价值。方法计算机检索Pub Med、EMbase、h e Cochrance Library(2013年第2期)、Wan Fang Data、VIP、CBM、CNKI和超星Medalink数据库,并手工检索相关中文期刊,收集有关AFU与AFP联合检测诊断原发性肝癌的文献,检索时限均为建库至2013年7月。由2位研究者独立按纳入与排除标准筛选文献、提取数据和评价纳入研究的方法学质量后,采用Meta-Di Sc 1.4软件进行Meta分析。结果共纳入20个研究,包括1 350例病例,2 079例对照。Meta分析结果显示:1单独检测AFU:SEN合并=0.76[95%CI(0.74,0.78)]、SPE合并=0.83[95%CI(0.82,0.85)]、+LR合并=7.09[95%CI(4.34,11.58)]、–LR合并=0.29[95%CI(0.23,0.37)]、DOR合并=26.88[(95%CI(15.04,48.06)]、SROC曲线下面积AUC=0.872 6和Q指数=0.803。2单独检测AFP:SEN合并=0.69[95%CI(0.67,0.72)]、SPE合并=0.88[95%CI(0.86,0.89)]、+LR合并=7.85[95%CI(5.35,11.50)]、–LR合并=0.35[95%CI(0.30,0.42)]、DOR合并=25.62[95%CI(16.35,40.15)]、SROC曲线下面积AUC=0.805 4和Q指数=0.740 6。3联合检测AFU和AFP:SEN合并=0.85[95%CI(0.83,0.87)]、SPE合并=0.86[95%CI(0.85,0.88)]、+LR合并=7.16[95%CI(5.15,9.96)]、–LR合并=0.15[95%CI(0.10,0.23)]、DOR合并=54.07[(95%CI(29.85,97.95)]、SROC曲线下面积AUC=0.940 8和Q指数=0.878 5。结论 AFU与AFP联合检测诊断原发性肝癌具有较高的诊断效能。

Objectives To systematically review serum a-L Fucose Gan Enzyme （AFU） combined with serum A1pha-Fetoprotein （AFP） in the diagnosis of primary hepatic carcinoma （PHC）. Methods We comprehensively searched databases including PubMed, The Cochrane Library （Issue 2, 2013）, WanFang Data, VIP, CBM, CNKI, EMbase, and Me dalink for relevant studies on AFU combined with AFP in the diagnosis of PHC from inception to July 2013; meanwhile, manual search for the relevant Chinese journals were also performed. Two reviewers independently screened literature ac cording to inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Then meta-analysis was performed using Meta-DiSc 1.4 software. Results A total of 20 studies involving 1 350 cases and 2 079 controls were included. The results of meta-analysis showed that, pooled sensitivity, specificity, positive likelihood radio, negative likelihood radio, diagnostic odds ratio, the area under SROC curve and Q index were： a） detection of AFU alone： 0.76 （0.74, 0.78）, 0.83 （0.82, 0.85）, 7.09 （4.34, 11.58）, 0.29 （0.23, 0.37）, 26.88 （15.04, 48.06）, 0.872 6 and 0.803, respectively; b） detection of AFP alone： 0.69 （0.67, 0.72）, 0.88 （0.86, 0.89）, 7.85 （5.35, 11.50）, 0.35 （0.30, 0.42）, 25.62 （16.35, 40.15）, 0.805 4 and 0.740 6, respectively; and c） combined detection of AFU and AFP： 0.85 （0.83, 0.87）, 0.86 （0.85, 0.88）, 7.16 （5.15, 9.96）, 0.15 （0.10, 0.23）, 54.07 （29.85, 97.95）, 0.940 8 and 0.878 5, respectively. Conclusion The combination detection of AFU and AFP has good efficacy in the diagnosis of PHC.