生存素mRNA检测对恶性胸腔积液诊断价值的Meta分析

DIAGNOSTIC PERFORMANCE OF SURVIVIN MRNA MEASUREMENT FOR MALIGNANT PLEURAL EFFUSION:A META-ANALYSIS

目的系统评价检测生存素mRNA对恶性胸腔积液的临床诊断价值。方法计算机检索Pubmed、Embase、万方数据、中国期刊全文数据库、维普网等数据库,筛选利用检测生存素mRNA诊断恶性胸腔积液的研究。所纳入文献的质量利用诊断性试验准确性质量评价工具评价,利用Meta-Disc 1.4软件计算纳入研究的合并敏感度、特异度、阳性似然比、阴性似然比与诊断比值比,绘制汇总受试者工作特征曲线,计算曲线下面积。结果根据设定纳入标准,共有7篇文献纳入本次Meta分析,Meta分析显示生存素mRNA对恶性胸腔积液的合并诊断价值分别为:敏感度为0.81[95%CI(0.77,0.85)],特异度为0.84[95%CI(0.79,0.88)],阳性似然比8.24[95%CI(2.44,27.89)],阴性似然比0.22[95%CI(0.13,0.36)],诊断比值比为41.55[95%CI(13.85,124.63)]。汇总受试者工作特征曲线下面积为0.92。结论生存素mRNA检测对恶性胸腔积液具有一定的诊断价值,可作为诊断恶性胸腔积液的辅助检测指标。

Objective To determine the accuracy of survivin mRNA detection in the diagnosis of malignant pleural effusion.Methods A systematic review was conducted in Pubmed,Embase,WanFang Data,China National Knowledge Infrastructure databases,and VIP Information and data on the accuracy of survivin mRNA in the diagnosis of malignant pleural effusion were pooled.The methodological quality was evaluated by QUADAS.Statistical analysis was performed employing Meta-Disc 1.4 software to calculate pooled sensitivity,specificity,positive/negative likelihood ratio and diagnostic odds ratio.Summary receiver operating characteristic（SROC）curve was used to summarize the overall diagnostic performance.Results Seven studies met the inclusion criteria for this meta-analysis.The summary estimates for survivin mRNA in the diagnosis of malignant pleural effusion were：sensitivity was 0.81（95%CI 0.77,0.85）,specificity was 0.84（95%CI 0.79,0.88）,positive likelihood ratio was 8.24（95%CI 2.44,27.89）,negative likelihood ratio was 0.22（95%CI 0.13,0.36）,diagnostic odds ratio was 41.55（95%CI 13.85,124.63）,and the area under the SROC curve was 0.92.Conclusion Survivin mRNA plays a role in the diagnosis of malignant pleural effusion,it may be an important assistant diagnostic marker for malignant pleural effusion.