甲胎蛋白异质体诊断原发性肝癌价值的Meta分析

VALUE OF ALPHA-FETOPROTEIN-L3 IN THE DIAGNOSIS OF PRIMARY HEPATIC CARCINOMA:A META-ANALYSIS

目的采用Meta分析评价甲胎蛋白异质体(AFP-L3)诊断原发性肝癌(PHC)的价值。方法检索Pubmed、Embase、中国知网、万方、维普等数据库中有关AFP-L3诊断PHC的相关文献,按照纳入及排除标准进行文献筛选。采用QUADAS-2评价纳入文献的偏倚风险。采用Meta Dis C1.4综合评价AFP-L3对PHC病人的诊断价值。结果本研究共纳入14篇文献,Meta分析提示纳入文献具有非阈值效应而引起的异质性。随机效应模型分析显示合并灵敏度为0.68(95%CI=0.66~0.70),合并特异度为0.91(95%CI=0.90~0.92),SROC曲线下面积(AUC)为0.907(95%CI=0.83~0.92),诊断比值比为35.79(95%CI=22.06~58.07)。结论AFP-L3对PHC病人的早期诊断具有较高的特异度和较大的AUC,对PHC的早期临床诊断具有一定的价值。

Objective To investigate the value of alpha-fetoprotein-L3(AFP-L3)in the diagnosis of primary hepatic carcinoma(PHC)through a Meta-analysis.Methods The databases including PubMed,Embase,CNKI,Wanfang Data,and VIP were searched for the articles on AFP-L3 in the diagnosis of PHC,and the articles were screened based on including and exclusion criteria.The QUADAS-2 tool was used to evaluate the risk of bias of included articles.Meta Dis C1.4 was used to investigate the diagnostic value of AFP-L3 in patients with PHC.Results A total of 14 articles were included,and the meta-analysis showed that the heterogeneity of the included studies was caused by the non-threshold effect.The random effects model analysis showed a pooled sensitivity of 0.68(95%confidence interval(CI):0.66-0.70),a pooled specificity of 0.91(95%CI:0.90-0.92),an area under the summary receiver operating characteristic curve(AUC)of 0.907(95%CI:0.83-0.92),and a diagnostic odds ratio of 35.79(95%CI:22.06-58.07).Conclusion AFP-L3 has high specificity and AUC in the early diagnosis of PHC,and therefore,it has a certain value in the early clinical diagnosis of primary liver cancer.