RT-PCR技术检测尿液中survivin mRNA对膀胱癌诊断价值的系统评价

发布时间：2019-03-03 14:20

【摘要】：背景与目的:Survivin基因逐渐成为肿瘤诊断、判断预后和治疗的靶点。用RT-PCR技术检测尿液中survivin mRNA作为一种无创性手段用于膀胱癌的诊断,国内外相关研究较多,但其结果不一。本研究旨在应用系统评价方法对相关文献进行客观评价,以评估RT-PCR技术检测尿液中survivin mRNA对膀胱癌的诊断价值。方法:以膀胱肿瘤、生存素、逆转录-聚合酶链反应、敏感度、特异度、诊断等为主要检索词检索PubMed、EMBASE、SCI、Cochrane Library、中国生物医学文献数据库(CBM)、相关期刊论文(CJFD)、中文科技期刊数据库(CSJD)、中华医学会数字化期刊等数据库,并结合Google Scholar等搜索引擎全面搜集1997年到2009年4月关于RT-PCR检测尿液survivin mRNA诊断膀胱癌的研究。根据QUADAS(quality assessment of diagnostic accuracy studies)质量评价标准评价纳入文献质量,用Meta-Disc软件对结果指标进行分析。结果:最终纳入26个研究,共2416例。Meta分析结果显示,RT-PCR技术检测尿液中survivin mRNA诊断膀胱癌与病理检查相比准确度指标合并敏感度、特异度、阳性似然比、阴性似然比及SROC曲线下面积分别为88%、94%、14.56、0.13、0.9736;巢式RT-PCR技术检测的敏感度、特异度及SROC曲线下面积最高,分别为91%、95%、0.9805;普通RT-PCR技术检测的敏感度和特异度次之,分别为87%和94%;定量RT-PCR技术检测的敏感度为80%,特异度为93%。结论:与病理检查相比,RT-PCR技术检测尿液中survivin mRNA诊断膀胱癌有较高的敏感度和特异度,可作为膀胱镜检查的主要辅助手段之一,用于膀胱癌的筛查及术后监测。
[Abstract]:Background & objective: Survivin gene has gradually become a target for tumor diagnosis, prognosis and treatment. The detection of survivin mRNA in urine by RT-PCR is a non-invasive method for the diagnosis of bladder cancer. There are many related studies at home and abroad, but the results are not the same. The aim of this study was to evaluate the diagnostic value of RT-PCR in the detection of urinary survivin mRNA in bladder cancer by systematically evaluating the related literatures. Methods: using bladder tumor, survivin, reverse transcription-polymerase chain reaction (RT-PCR), sensitivity, specificity and diagnosis as the main search words, we searched PubMed,EMBASE,SCI,Cochrane Library, Chinese Biomedical Literature Database (CBM),). Chinese journal full-text database (CJFD), Chinese sci-tech journal database (CSJD), Chinese medical association digital journals and other databases, Combined with Google Scholar and other search engines, a comprehensive collection of RT-PCR detection of urine survivin mRNA diagnosis of bladder cancer research from 1997 to April 2009. According to the QUADAS (quality assessment of diagnostic accuracy studies) quality evaluation criteria, the results were analyzed by Meta-Disc software. Results: a total of 2416 cases were included in 26 studies. The results of meta-analysis showed that the accuracy index, sensitivity, specificity and positive likelihood ratio of RT-PCR technique in the diagnosis of bladder cancer were higher than that of pathological examination, and the sensitivity, specificity and positive likelihood ratio were higher than those of pathological examination. The negative likelihood ratio and the area under SROC curve were 88%, 94%, 14.56, 0.13,0.9736, respectively. The sensitivity, specificity and area under SROC curve of nested RT-PCR were the highest, which were 91%, 95%, 0.9805, respectively, and the sensitivity and specificity of common RT-PCR were 87% and 94%, respectively. The sensitivity and specificity of quantitative RT-PCR were 80% and 93% respectively. Conclusion: compared with pathological examination, RT-PCR technique has higher sensitivity and specificity in the diagnosis of bladder cancer. It can be used as one of the main auxiliary methods of cystoscopy to screen bladder cancer and monitor it after operation.
【作者单位】：兰州大学循证医学中心;兰州大学基础医学院生物化学与分子生物学研究所;
【分类号】：R737.14

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