切换至 "中华医学电子期刊资源库"
高级检索
中华妇幼临床医学杂志(电子版)

中华妇幼临床医学杂志(电子版) ›› 2012, Vol. 08 ›› Issue (03) : 290 -294. doi: 10.3877/cma.j.issn.1673-5250.2012.03.010

所属专题： 专题评论； 文献；

论著

血清人附睾蛋白联合糖链抗原－125检测在卵巢癌诊断中作用的系统评价
黄慧琼1, 唐静1, 彭鸿灵1, 赵霞1,*,*()   
  1. 1. 610041　成都，四川大学华西第二医院妇产科
  • 收稿日期:2012-02-27 修回日期:2012-04-23 出版日期:2012-06-01
  • 通信作者: 赵霞

Diagnostic Value of Combining Detection of Serum Human Epididymis Protein and Carbohydrate Antigen-125 on Ovarian Cancer: A Meta-Analysis

Hui-qiong HUANG1, Jing TANG1, Hong-ling PENG1, Xia ZHAO1()   

  1. 1. Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
  • Received:2012-02-27 Revised:2012-04-23 Published:2012-06-01
  • Corresponding author: Xia ZHAO
  • About author:
    (Corresponding author: ZHAO Xia, Email: )
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

黄慧琼, 唐静, 彭鸿灵, 赵霞. 血清人附睾蛋白联合糖链抗原－125检测在卵巢癌诊断中作用的系统评价[J]. 中华妇幼临床医学杂志(电子版), 2012, 08(03): 290-294.

Hui-qiong HUANG, Jing TANG, Hong-ling PENG, Xia ZHAO. Diagnostic Value of Combining Detection of Serum Human Epididymis Protein and Carbohydrate Antigen-125 on Ovarian Cancer: A Meta-Analysis[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2012, 08(03): 290-294.

目的

系统评价血清人附睾蛋白(HE4)联合糖链抗原－125(CA125)测定对卵巢癌的诊断价值及临床应用前景。

方法

计算机检索Cochrane图书馆、Medline、Pubmed、中国生物医学文献数据库(CBM)、中文科技期刊全文数据库[维普(VIP)]等数据库，检索年限均从建库至2012年2月，收集有关血清HE4联合CA125检测诊断卵巢癌的诊断试验，手工检索相关会议论文集、学位论文汇编等。根据Cochrane系统评价方法筛选研究并提取数据，采用Meta－DiSc 1.4软件进行Meta分析(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准，得到该委员会批准)。

结果

12篇文献符合纳入标准纳入本系统评价，其中卵巢癌病例组为848例，正常或非卵巢癌病例对照组为1468例。各研究之间存在异质性，按照随机效应模型计算，CA125单独检测及CA125联合HE4检测，对卵巢癌诊断的汇总灵敏度、阴性似然比、诊断比值比(DOR)，受试者工作特征曲线下面积SROC AUC及Cochrane－Q指数分别为：81%(95%CI：0.79～0.84)与93%(95%CI：0.92～0.95)；0.26(95%CI：0.22～0.32)与0.10(95%CI：0.07～0.14)；14.02(95%CI：8.50～23.11)与56.46(95%CI：34.86～91.47)及0.8697与0.9544；0.802 00与0.896 05。

结论

HE4作为诊断卵巢癌的新型肿瘤标志物与CA125联合检测，可提高卵巢癌的诊断准确率。

关键词: 人附睾蛋白, 联合糖链抗原－125, 卵巢癌, 诊断, Meta分析
Objective

To conduct a Meta-analysis based on the evaluation of serum carbohydrate antigen-125 (CA125) combine with human epididymis protein (HE)4 in diagnosis of ovarian cancer.

Methods

Based on the principles and methods of Cochrane systematic reviews, literatures were publicated from inception to February 2012, including English or Chinese languages, were searched in Cochrane Library, Medline, Pubmed, China National Knowledge Infrastructure (CNKI), CBM, VIP databases. Articles related to the diagnostic value of serum CA125 combine with HE4 in ovarian cancer were selected, related journals were also searched manually. Data analysis was conducted by Meta-Disc 1.4 software. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of West China Second University Hospital, Sichuan University.

Results

A total of 12 articles with 848 ovarian cancer cases and 1468 controls were included. The pooled sensitivity of CA125 alone and CA125 combined with HE4 were 81% (95% CI: 0.79-0.84) and 93%(95%CI: 0.92-0.95), respectively, and the negative likelihood ratio(N-LR) were 0.26(95%CI: 0.22-0.32) and 0.10(95%CI: 0.07-0.14), diagnosis odds ratio(DOR) were 14.02 (95%CI: 8.50-23.11) and 56.46 (95%CI: 34.86-91.47), summary receiver operating characteristic curve area under curve (SROC AUC)were 0.8697 and 0.9544, Cochrane-Q index were 0.802 00 and 0.896 05, respectively.

Conclusions

HE4, as a new tumor maker, combine with CA125, could be an effective tool for the diagnosis of ovarian cancer.

Key words: human epididymis protein, carbohydrate antigen-125, ovarian cancer, diagnosis, Meta-analysis
表1 纳入研究的四格表资料
Table 1 Fourfold table information
作者 国家 纳入人群 患病率 n 真阳性 假阳性 假阴性 真阴性
? CA125检测诊断卵巢癌 ? ? ? ? ? ? ? ?
? Wang[8] China，2011 1 2 308 97 57 22 132
? Knapp[9] USA，2010 1 1 472 113 95 15 249
? Modarres－Gilani[10] Iran，2011 1 2 87 31 0 6 50
? Andersen[11] USA，2010 1 2 211 60 7 14 130
? Abdel－Azeez[12] Egypt，2010 1 3 65 30 5 11 19
? Viikant[13] Estonia，2011 1 1 254 125 40 18 71
? Holcomb[14] USA，2011 2 2 229 15 93 3 118
? Liu[15] China，2010 1 2 131 71 14 21 25
? Hu[16] China，2011 2 2 140 41 18 17 64
? Jing[17] China，2011 1 1 100 32 4 10 54
? Yang[18] China，2010 2 3 86 24 28 8 26
? Ou[19] China，2010 2 2 233 51 27 13 142
CA125联合HE4检测 ? ? ? ? ? ? ? ?
? Wang[8] China，2011 1 2 308 110 51 9 134
? Knapp[9] USA，2010 1 1 472 122 80 6 264
? Mitra[10] Iran，2011 1 2 87 36 0 1 50
? Andersen[11] USA，2010 1 2 211 66 14 8 123
? Abdel－Azeez[12] Egypt，2010 1 3 65 37 5 4 19
? Viikant[13] Estonia，2011 1 1 254 142 48 1 53
? Holcomb[14] USA，2011 2 2 229 17 101 1 110
? Liu[15] China，2010 1 2 131 87 14 5 25
? Hu[16] China，2011 2 2 140 46 2 12 80
? Jing[17] China，2011 1 1 100 40 5 2 53
? Yang[18] China，2010 2 3 86 30 27 2 25
? Ou[19] China，2010 2 2 233 59 29 5 140
图1 CA125单独检测与CA125联合HE4检测诊断卵巢癌敏感度和特异度森林图
Figure 1 Sensitivity and specificity forest plots of CA125 or CA125 combination with HE4
图2 CA125单独检测与CA125联合HE4检测诊断卵巢癌阴性似然比和诊断比值比森林图
Figure 2 Negative likelihood ratio and diagnosis odds ratio forest plots of CA125 or CA125 combination with HE4
[1]
Drapkin R, Hecht JL. The origins of ovarian cancen hurdles and progress[J].Women's Oncol Rev, 2002, 2(1):261-268.
[2]
Drapkin R, von Horsten HH, Lin Y, et al. Human epididymis protein 4 (HE4) is a secreted glycoprotein that is overexpressed by serous and endometrioid ovarian carcinomas[J]. Cancer Res, 2005, 65(6):2162-2169.
[3]
Kirchhoff C, Habben I, Ivell R, et al. A major human epididym is specific cDNA encodes a protein with sequence homology to extracellular proteinase inhibitors[J]. Biol Reprod, 1991, 45(2):350-357.
[4]
Hellsrom I, Raycraft J, Haydened LM, et al. The HE4(WFDC2) protein is a biomarker for ovarian carcinoma[J]. Cancer Res, 2003, 63(13):3695-3700.
[5]
Pickle LW, Hao Y, Jemal A, et al.A new method of estimating United States and state-level cancer incidence counts for the current calendar year[J].CA Cancer J Clin, 2007, 57(1):30-42.
[6]
Kirehhoff C, Habben I, Dell R, et al. Amajor human epididymis-specific cDNA encodes a protein with sequence homology to extracellular proteinase inhibitors[J].Biol Reprod, 1991, 45:350-357.
[7]
Orals R, Rubin S, Thomas G, et al.Epithelial ovarian cancer[M].Philadelphia:Lippincott Williams and Wilkins, 2000, 36-38.
[8]
Wang MJ, Qi J. Diagnostic value of combining detection of human epididymis protein 4 and CA125 in patients with malignant ovarian carcinoma[J]. Chin J Oncol, 2011, 33(7):540-543.
[9]
Knapp R, Recio FO. Elevation of HE4 and CA125 for epithelial ovarian cancer detection in high-risk patients with symptoms and adnexal mass[J]. Int J Gynecol Cancer, 2011, 21(3):S361.
[10]
Modarres-Gilani M, Ghaemmaghami MF. Simultaneous measurement of two serum markers(CA125 and HE4) while diagnosing malignant ovarian epithelial tumors[J]. Pakistan J Med Sci, 2011, 27(4):858-861.
[11]
Andersen MR, Goff BA. Use of a symptom Index, CA125, and HE4 to predict ovarian cancer[J]. Gynecol Oncol, 2010, 116(3):378-383.
[12]
Abdel-Azeez HA, LabibHA. HE4 and mesothelin:Novel biomarkers of ovarian carcinoma in patients with pelvic masses[J]. Asian Pacific J Cancer Prevent:Apjcp, 2010, 11(1):111-116.
[13]
Viikant N, Fomichev M. Tumour marker HE4 in patients with ovarian cancer[J]. Clin Chemist Lab Med, 2011, 49(Suppl 1):S280.
[14]
Holcomb K, Vucetic Z. Human epididymis protein 4 offers superior specificity in the differentiation of benign and malignant adnexal masses in premenopausal women[J]. Am J Obstet Gynecol, 2011, 205(4):358, e351-356.
[15]
Liu GR, Wang AL, Liu Q, et al. Combined detection of serum CA125 and human epididymis protein 4 levels in ovarian cancer[J]. Chin J Clin Lab Sci, 2010, 28(2):119-121.
[16]
Hu XT, Liu LJ, Gao JQ, et al. Values of human sapiens epididymis specific protein 4 combined with carbohydrate antigen 125 in diagnosis of human ovarian cancer[J]. Chin Gen Pract, 2011, 14(7C):2411-2413.
[17]
Jing XG, Wang GJ, Pei YX, et al. Clinical value of serum CA125 and CA123 combined with HE4 detection in the diagnosis of epithelial ovarian cancer[J]. Acta Academiae Med Militaris Tertiae, 2011, 33(6):644-645.
[18]
Yang C, Song ML, Zhong HB, et al. The differentialdiagnostic value of HE4, CA125 and the risk of ovarian malignancy algorithm in ovarian tumor[J]. Suzhou Univ J Med Sci, 2010, 30(4):795-798.
[19]
Ou J, Zhang XX, Wang CC, et al. Detection of serum human epididymis protein 4 and its significance in diagnosis of ovarian cancer[J].J Jilin Univ:Med Ed, 2010, 36(3):543-545.
[1] 杨水华, 何桂丹, 覃桂灿, 梁蒙凤, 罗艳合, 李雪芹, 唐娟松. 胎儿孤立性完全型肺静脉异位引流的超声心动图特征及高分辨率血流联合时间-空间相关成像的应用[J]. 中华医学超声杂志（电子版）, 2023, 20(10): 1061-1067.
[2] 李培杰, 乔永杰, 张浩强, 曾健康, 谭飞, 李嘉欢, 王静, 周胜虎. 细菌培养阴性的假体周围感染诊治的最新进展[J]. 中华关节外科杂志(电子版), 2023, 17(06): 827-833.
[3] 彭旭, 邵永孚, 李铎, 邹瑞, 邢贞明. 结肠肝曲癌的诊断和外科治疗[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 108-110.
[4] 李智铭, 郭晨明, 庄晓晨, 候雪琴, 高军喜. 早期乳腺癌超声造影定性及定量指标的对比研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 639-643.
[5] 杨雪, 张伟, 尚培中, 宋创业, 尚丹丹, 张蔚. 胆囊十二指肠瘘结石经瘘口排出后自愈一例报道[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 707-708.
[6] 姜明, 罗锐, 龙成超. 闭孔疝的诊断与治疗：10年73例患者诊疗经验总结[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 706-710.
[7] 许丁伟, 马江云, 李新成, 黄洁. Alagille综合征疑诊为先天性胆道闭锁一例并文献复习[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 681-687.
[8] 蓝冰, 王怀明, 王辉, 马波. 局部晚期结肠癌膀胱浸润的研究进展[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 505-511.
[9] 杨红杰, 张智春, 孙轶. 直肠癌淋巴结转移诊断研究进展[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 512-518.
[10] 赵立力, 王魁向, 张小冲, 李志远. 血沉与C-反应蛋白比值在假体周围感染中的诊断价值分析[J]. 中华老年骨科与康复电子杂志, 2023, 09(06): 351-355.
[11] 吴凤芸, 滕鑫, 刘连娟. 高帧频超声造影与增强磁共振对不同直径原发性高分化肝细胞癌的诊断价值[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 404-408.
[12] 孙欣欣, 刘军, 陈超伍, 孙超. 超声内镜引导细针穿刺抽吸术在胰腺占位性病变中的应用[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 418-421.
[13] 袁媛, 赵良平, 刘智慧, 张丽萍, 谭丽梅, 閤梦琴. 子宫内膜癌组织中miR-25-3p、PTEN的表达及与病理参数的关系[J]. 中华临床医师杂志(电子版), 2023, 17(9): 1016-1020.
[14] 李田, 徐洪, 刘和亮. 尘肺病的相关研究进展[J]. 中华临床医师杂志(电子版), 2023, 17(08): 900-905.
[15] 周婷, 孙培培, 张二明, 安欣华, 向平超. 北京市石景山区40岁及以上居民慢性阻塞性肺疾病诊断现状调查[J]. 中华临床医师杂志(电子版), 2023, 17(07): 790-797.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号