血清磷脂酰肌醇蛋白多糖-3检测对中国人群肝癌诊断价值的系统评价

Diagnostic Value of Serum GPC-3 Detection for Liver Cancer in Chineses Population: a meta Analysis

目的采用系统评价的方法将血清磷脂酰肌醇蛋白多糖-3(glypican-3,GPC-3)对中国肝癌患者的诊断准确性进行评估。方法通过互联网对Pubmed、Embase、The Cochrane Library、中国知网期刊数据库(CNKI)、万方数据库进行检索,收集有关GPC-3诊断肝癌的文献,检索时限定义为建库——2015年2月。使用QUADAS量表对纳入文献质量进行评估。通过meta-disc 1.4软件对血清GPC-3诊断肝癌的敏感度(SEN)、特异度(SPE)、阳性似然比(PLR)、阴性似然比(NLR)、诊断比值比(DOR)分别进行合并,并计算SROC曲线下面积(AUC)。发表偏倚的影响用漏斗图和Egger's检验评估。结果 8个研究纳入最终评价,研究对象共计1679例。纳入文献存在显著异质性(P<0.001),采用随机效应模型进行评估。血清GPC-3诊断肝癌的合并SEN为0.52(95%CI:0.49,0.55),SPE为0.84(95%CI:0.80,0.87),PLR为4.41(95%CI:1.85,10.49),NLR为0.57(95%CI:0.44,0.74),DOR为8.95(95%CI:2.81,28.52),AUC为0.6876。采用漏斗图和Egger's检验未发现发表偏倚存在(P=0.526)。结论血清GPC-3在肝癌的诊断中SEN较低,但是SPE较高,临床确诊需联合其他诊断指标,以进一步提高肝癌诊断的准确度。

Objective To evaluate the diagnostic accuracy of serum glypican-3 （GPC-3） detection for liver cancer in Chinese patients using system evaluation method. Methods The studies on liver cancer patients diagnosed with GPC-3 detection method were searched from PubMed, Embase, the Cochrane Library, Wanfang and CNKI databases （ database establishment- February 2015 ） , and the quality of relevant articles was evaluated using QUADAS rating scale. The sensitivity （SEN）, specificity （SPE）, positive likelihood ratio （PLR）, negative likelihood ratio （NLR） and diag- nosis odds ratio （DOR） of liver cancer patients diagnosed with serum GPC-3 detection method were respectively com- bined using meta-disc 1.4 software, and the area under curve （ AUC ） of SROC was calculated. The publication bias was evaluated using funnel plot and Egger$ test. Results A total of 8 studies including 1679 subjects were recruited in this study. The studies had significant heterogeneity with evaluation of random effect model （P 〈 0.001 ）. The combined SEN, SPE, PLR, NLR and DOR were 0.52 E95% confidence interval （CI） ： 0.49, 0.55] , 0.84 （95% CI ： 0.80, 0.87）, 4.41 （95% CI ： 1.85, 10.49）, 0.57 （95% CI ：0.44,0.74） and 8.95 （95% CI ：2.81,28.52） respec- tively. The AUC was 0. 6876. The funnel plot and Egger＇s test showed no evidence of publication bias （ P = 0. 526）. Conclusion Although the diagnostic accuracy of serum GPC-3 for early liver cancer is still unsatisfactory, the serum GPC-3 has significantly specificity, and the diagnostic accuracy can be improved through combining with other diagnostic indexes.