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

doi:10.3877/cma.j.issn.1673-5250.2012.03.010

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

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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