HE4和HE4/CA125并联诊断卵巢癌的系统评价

Evaluation of HE4 and CA125/HE4 Combining Diagnosis in Ovarian Cancer

目的:通过Meta分析方法系统评价血清人附睾蛋白4(HE4)及HE4并联糖类抗原125(CA125)诊断卵巢癌的价值。方法:中国知网期刊数据库(CNKI)、中文科技期刊数据库(中国万方数据库)、中文电子期刊数据库及维普网等数据库检索2005年1月至2015年3月的相关文献,使用Meta-Disc软件进行Meta分析,分析异质性及处理后选择适当效应模型合并效应量,得出合并敏感性、合并特异性及合并似然比,制作SROC曲线并计算曲线下面积(AUC)。对HE4及HE4/CA125并联检测诊断卵巢癌的AUC应用Z检验进行比较。采用STATA13.0软件应用Egger检验法进行发表偏倚检测。结果:16篇文献符合纳入标准,将对照组分为健康人群和良性疾病组,经Meta分析后得出:以健康人群为对照,HE4和HE4/CA125并联检测卵巢癌的AUC分别为0.8611±0.0399、0.8959±0.0237,差异无统计学意义(Z值=0.749871,P>0.05)。以良性疾病组为对照,HE4和HE4/CA125并联检测卵巢癌的AUC分别为0.9443±0.0153、0.9328±0.0132,差异无统计学意义(Z值=0.569105,P>0.05)。结论:HE4/CA125并联检测提高了卵巢癌检测的灵敏度,而单独检测HE4有良好的特异度,两者对卵巢癌诊断均有较高的AUC,但HE4与HE4/CA125并联检测的诊断价值差异并无统计学意义。

Objective： To evaluate the diagnostic value of HE4（ Human Epididymal Protein 4） and HE4 / CA125（ CA125） parallel detection for ovarian cancer by meta-analysis. Methods： The databases,including China National Knowledge Infractrure（ CNKI）,Wanfang Database and Vip database,were employed to search for studies related to diagnostic value of HE4 and HE4 / CA125 parallel detection for ovarian cancer. The screening,data extraction and quality assessment were conducted in accordance with the inclusion and exclusion criteria. The software Meta-disc 1. 4 was used to perform meta-analysis and draw the forest plots and the Summary Receiver Operating Characteristic（ SROC） curves.The AUCs of HE4,HE4 / CA125 parallel detection were detected by Z test. The Egger＇s regression test was applied to evaluate the publication bias by Stata13. 0. Results： A total of 16 studies with benign control and / or healthy control were included. In the studies with benign control,the AUCs of HE4,HE4 / CA125 parallel detection were 0. 8611 ± 0.0399 and 0. 8959 ± 0. 0237 respectively,but there was no significant difference between them（ Z = 0. 749871,P 〉0.05）; In the studies with benign control,the AUCs of HE4 and HE4 / CA125 were 0. 9443 ± 0. 0153 and 0. 9328 ± 0.0132 respectively,but there was no significant difference between them（ Z = 0. 569105,P 〉0. 05）. Conclusion： Both HE4 and HE4 / CA125 parallel detection had meaningful values for the diagnosis of ovarian cancer. The detection of HE4 had higher specificity,while the HE4 / CA125 parallel detection had higher sensitivity. But there was no statistical difference between them in diagnosis value of ovarian cancer.