甲胎蛋白、异常凝血酶原对原发性肝癌诊断价值的Meta分析

Meta analysis of the diagnostic value of alpha-fetoprotein and abnormal prothrombin in primary liver cancer

目的探讨甲胎蛋白(AFP)、异常凝血酶原(DCP)联合检测或单独检测在诊断原发性肝癌中的效能,为临床运用肿瘤标志物检测原发性肝癌的高效性和准确性提供依据。方法搜集万方、中国知网、维普、PubMed、Web of Science数据库中自建库以来至2020年11月2日联合检测AFP、DCP在原发性肝癌诊断中应用的相关文献并统计分析各个文献。结果本研究共纳入16篇文献,根据Meta分析结果显示,单独检测AFP的诊断比值比(DOR)、受试者工作特征曲线下面积(AUC)和Q指数分别为12.54(95%CI 8.38~18.77)、0.7803、0.7335;单独检测DCP的DOR、AUC和Q指数分别为42.88(95%CI 26.74~68.75)、0.9149、0.8476。联合检测AFP、DCP的DOR、AUC和Q指数分别为33.87(95%CI 19.94~57.52)、0.9309、0.8662。结论和单独检测比较,AFP、DCP联合检测能提高原发性肝癌早期诊断的灵敏度、诊断效能,具有较好的临床应用价值。

Objective To explore the efficacy of combined detection of alpha-fetoprotein(AFP)and abnormal prothrombin(DCP)or separate detection in the diagnosis of primary liver cancer,and to provide evidence for the high efficiency and accuracy of clinical application of tumor markers in the detection of primary liver cancer.Methods The literatures about the application of combined detection of AFP and DCP in the diagnosis of primary liver cancer in Wanfang,CNKI,VIP,PubMed and Web of Science database from the establishment to November 2,2020 were collected and statistically analyzed.Results A total of 16 articles were included in this study.According to the results of Meta analysis,the diagnostic odds ratio(DOR),area under the receiver operating characteristic curve(AUC)and Q index of AFP alone were 12.54(95%CI 8.38-18.77),0.7803,0.7335 respectively.The DOR,AUC and Q indexes of DCP were 42.88(95%CI 26.74-68.75),0.9149 and 0.8476 respectively.The DOR,AUC and Q indexes of combined detection of AFP and DCP were 33.87(95%CI 19.94-57.52),0.9309 and 0.8662 respectively.Conclusion Compared with separate detection,the combined detection of AFP and DCP can improve the sensitivity and diagnostic efficiency of the early diagnosis of primary liver cancer,and has better clinical application value.