血清HE4、CA125联合检测对子宫内膜癌诊断价值的Meta分析

发布时间：2019-05-30 02:47

【摘要】：目的：应用循证医学的方法对联合检测血清人附睾蛋白4(Human Epididymis Protein 4, HE4)和CA125水平在子宫内膜癌的诊断价值进行系统评价,为其诊断子宫内膜癌提供评价依据。方法：通过计算机检索英文数据库,包括Cochrane图书馆、Pubmed数据库、MEDLINE数据库、EMBase数据库,中文数据库包括中国知网、中国生物医学文献数据库(CBN)、维普中文期刊数据库及万方学位论文数据库,同时手工检索相关专业杂志,并追溯相关文献的参考文献,文章语种不限,全面收集联合检测血清HE4、CA125与金标准(内膜病理诊断)比较诊断子宫内膜癌的相关文献,检索时限均从创库至2015年1月,并由两位评价员分别单独根据设定好的纳入标准及排除标准对检索文献进行筛选,对纳入文献进行质量评价、提取资料及有效数据,用统计软件Revman5.0中的QUADAS量表进行质量评价、用Meta-Disc1.4软件对纳入研究的诊断试验结果进行Meta分析。结果：最终纳入文献12篇,样本量总共1995例,其中经过金标准(子宫内膜病理检查)确诊的子宫内膜癌患者有1075例、对照组920例(其中子宫良性病变者有359例、正常妇女有561例)。Meta分析结果显示：血清HE4+CA125检测诊断子宫内膜癌SEN合并=58%[95%CI(0.55,0.61)],SPE合并=92%[95%CI(0.90,0.93)],+LR合并=7.10[95%CI(3.54,14.27)],-LR合并=0.46[95%CI(0.39,0.53)],DOR合并=16.02[95%CI(7.69,33.37)],拟合SROC曲线下面积AUC=0.8696。结论：研究结果显示,血清HE4+CA125检测对子宫内膜癌诊断具有较高的敏感度、特异度及AUC值,说明联合检测血清HE4和CA125对子宫内膜癌的诊断有较高的临床应用价值。
[Abstract]:Objective: to evaluate the diagnostic value of combined detection of serum epididymal protein 4 (Human Epididymis Protein 4 (HE4) and CA125 in endometrial carcinoma by evidence-based medicine (EBM), and to provide evidence for the diagnosis of endometrial carcinoma. Methods: the English database was searched by computer, including Cochrane library, Pubmed database, MEDLINE database, EMBase database, Chinese database including China knowledge Network, Chinese Biomedical Literature Database (CBN),. Weipu Chinese periodical database and Wanfang dissertation database, at the same time manually search the relevant professional magazines, and trace back to the relevant literature references, the language of the article is not limited, comprehensive collection and joint detection of serum HE4, CA125 was compared with gold standard (pathological diagnosis of intima) in the diagnosis of intimal cancer, and the retrieval time was from the database to January 2015. the literature was compared with the gold standard (pathological diagnosis of intima). The retrieval literature was screened by the two evaluators separately according to the established inclusion standard and exclusion standard, and the quality of the included literature was evaluated, and the data and effective data were extracted. The quality of QUADAS scale in statistical software Revman5.0 was evaluated, and the diagnostic test results included in the study were analyzed by Meta software with Meta-Disc1.4 software. Results: a total of 1995 cases were included in 12 articles, of which 1075 cases were diagnosed by gold standard (endometrial pathological examination) and 920 cases in the control group (including 359 cases with benign uterine lesions). There were 561 normal women. Meta-analysis showed that serum HE4 CA125 was used to diagnose endometrial carcinoma with SEN in 58% [95%CI (0.55, 0.61)] and SPE in 92% [95%CI (0.90, 0.93)], and the results of meta-analysis showed that the diagnosis of endometrial carcinoma was 58% [95%CI (0.55, 0.61)], and 92% [95%CI (0.90, 0.93)]. LR merge = 7.10 [95%CI (3.54, 14.27)],-LR merge = 0.46 [95%CI (0.39, 0.53)], DOR merge = 16.02 [95%CI (7.69, 33.37)], fit area AUC=0.8696. under SROC curve Conclusion: the results show that the detection of serum HE4 CA125 has high sensitivity, specificity and AUC value in the diagnosis of endometrial carcinoma, which indicates that the combined detection of serum HE4 and CA125 has high clinical application value in the diagnosis of endometrial carcinoma.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R737.33

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