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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: )
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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/OL]. 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/OL]. 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
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