人附睾分泌蛋白4诊断子宫内膜癌的价值meta分析

Diagnostic Value of Human Epididymis Protein 4(HE4)in Diagnosis of Endometrial Cancer:A Meta-Analysis

目的系统评价人附睾分泌蛋白4(HE4)诊断子宫内膜癌的临床价值。方法计算机检索PubMed、The Cochrane Library、CNKI和Wan Fang Data数据库,搜集关于HE4诊断子宫内膜癌的诊断性试验,检索时限从建库至2018年12月。由两位研究者独立筛选文献、提取资料和评价偏倚风险后,采用Stata14.0软件进行统计分析,计算其合并敏感度(Sen合并)、特异性(Spe合并)、诊断比值比(DOR),绘制汇总受试者工作特征(SROC)曲线并计算曲线下面积(AUC)。结果共纳入17个研究,包括2990例患者。Meta分析结果显示:HE4诊断子宫内膜癌的Sen合并、Spe合并、DOR分别为0.58[95%(0.52,0.64)]、0.95[95%(0.89,0.98)]、24[95%(12,50)],AUC为0.74[95%(0.7,0.78)]。结论当前证据显示,HE4诊断子宫内膜癌的特异性较高而敏感度较低,单独应用时漏诊率较高,应与其他检查手段联合应用。

Objective To estimate the diagnostic value of human epididymis protein 4(HE4)in endometrial cancer. Methods PubMed, The Cochrane Library, CNKI and WanFang Data databases from the establishment of the database to December, 2018 were searched to collect relevant diagnostic accuracy studies of HE4 in endometrial cancer. Two reviewers independently screened lit erature,extracted data and assessed the risk of bias of included studies. Statistical analysis was performed using Stata 14.0 software. The pooled sensitivity, specificity and diagnostic odds ratio were calculated, the summary receiver operating characteristic curve (SROC)was drawn,and the area under the curve(AUC)was calculated. Results 17 studies involving 2 990 patients were included. The pooled sensitivity,specificity,DOR were 0.58[95%(0.52,0.64)],0.95[95%(0.89,0.98)]and 24[95%(12,50)],re spectively. The AUC were 0.74[95%(0.7,0.78)]. Conclusion The current evidence indicates that HE4 in diagnosis of endometrial cancer has high specificity and low sensitivity,which leads to a high misdiagnosis rate when used alone,so it should be combined wi thother laboratory examinations.