腹水癌胚抗原和细胞角蛋白检测对胃癌患者预后评估价值的Meta分析

The value of detection of the prognosis of gastric cancer patients by the detection of the antigen of ascites and the detection of cell keratin:A Meta analysis

目的系统评价腹水癌胚抗原（CEA）和细胞角蛋白（CK20）检测对胃癌患者预后评估的价值。方法计算机检索PubMed、EMbase、The Cochrane Library、CBM、CNKI、VIP和WanFang Data,收集符合纳入标准的研究,检索时限均为从建库—2016年3月,并追溯纳入研究的参考文献和手工检索相关会议资料。由2位研究者按照纳入与排除标准独立筛选文献、提取资料和评价质量后,采用RevMan5.2软件进行Meta分析。结果共纳入11篇符合标准的病例对照研究,共1 221例患者。Meta分析结果显示,与腹水CEA/CK20阳性组相比较,CEA/CK20阴性组术后总生存率明显改善（HR=0.84,95%CI 0.78~0.90,P〈0.01）;无病生存率无统计学差异（HR=1.19,95%CI 0.93~1.52,P=0.17）;无腹膜复发生存率明显改善（HR=0.87,95%C1 0.76~0.98,P=0.02）;亚组分析显示,CEA及CK20联合检测对胃癌患者的远期预后判断价值优于CEA单一检测。结论对于胃癌患者,在疾病早期阶段开展腹水CEA及CK20检测,为手术方式的选择及术后治疗提供参考,可有效提高患者的远期生存率。

Objective To evaluate of the prognosis of patients with gastric cancer by systematic review ot ascites cancer embryo antigen（CEA） and cell keratin（CK20）.Methods We searched literature concerning studies on the prognostic significance of peritoneal fluid detection of CEA or CK20 in gastric cancer patients from PubMed,Cochrane Library,Embase,CNKI,Wanfang database with the time range of searching set from establishment of the databases to March 2016.Meta analysis was conducted using the Cochrane Collaborations RevMan 5.2 software.Results A total of 11 articles met criteria were included in the study.A total of 1 221 patients were enrolled.The results of Meta analysis showed that compared with ascites CEA/CK20 positive group and CEA/CK20 negative group postoperative survival rate significantly improved（HR =0.84,95%CI 0.78-0.90,P〈0.01）;disease free survival rate showed no significant difference（HR = 1.19,95%CI 0.93-1.52,P =0.17）;no peritoneal recurrence survival rate improved significantly（HR =0.87,95%CI 0.76-0.98,P =0.02）;subgroup analysis showed that CEA and CK20 combined detection of the long-terra prognosis of patients with gastric cancer is better than that of single CEA detection value judgment.Conclusion For patients with gastric cancer,in the early stage of disease to carry out CEA and CK20 detection of ascites,to provide reference for the choice of surgical methods and postoperative treatment,can effectively improve the long-term survival rate of patients.