HE4和HE4/CA125并联诊断卵巢癌的系统评价

目的:通过Meta分析方法系统评价血清人附睾蛋白4(HE4)及HE4并联糖类抗原125(CA125)诊断卵巢癌的价值。方法:中国知网期刊数据库(CNKI)、中文科技期刊数据库(中国万方数据库)、中文电子期刊数据库及维普网等数据库检索2005年1月至2015年3月的相关文献,使用Meta-Disc软件进行Meta分析,分析异质性及处理后选择适当效应模型合并效应量,得出合并敏感性、合并特异性及合并似然比,制作SROC曲线并计算曲线下面积(AUC)。对HE4及HE4/CA125并联检测诊断卵巢癌的AUC应用Z检验进行比较。采用STATA13.0软件应用Egger检验法进行发表偏倚检测。结果:16篇文献符合纳入标准,将对照组分为健康人群和良性疾病组,经Meta分析后得出:以健康人群为对照,HE4和HE4/CA125并联检测卵巢癌的AUC分别为0.8611±0.0399、0.8959±0.0237,差异无统计学意义(Z值=0.749871,P0.05)。以良性疾病组为对照,HE4和HE4/CA125并联检测卵巢癌的AUC分别为0.9443±0.0153、0.9328±0.0132,差异无统计学意义(Z值=0.569105,P0.05)。结论:HE4/CA125并联检测提高了卵巢癌检测的灵敏度,而单独检测HE4有良好的特异度,两者对卵巢癌诊断均有较高的AUC,但HE4与HE4/CA125并联检测的诊断价值差异并无统计学意义。

Evaluation of HE4 and CA125/HE4 Combining Diagnosis in Ovarian Cancer

Objective:To evaluate the diagnostic value of HE4 (Human Epididymal Protein 4)and HE4 /CA125 (CA125)parallel detection for ovarian cancer by meta-analysis.Methods:The databases,including China National Knowledge Infractrure (CNKI),Wanfang Database and Vip database,were employed to search for studies related to di-agnostic value of HE4 and HE4 /CA125 parallel detection for ovarian cancer.The screening,data extraction and quality assessment were conducted in accordance with the inclusion and exclusion criteria.The software Meta-disc 1.4 was used to perform meta-analysis and draw the forest plots and the Summary Receiver Operating Characteristic (SROC)curves. The AUCs of HE4,HE4 /CA125 parallel detection were detected by Z test.The Egger’s regression test was applied toevaluate the publication bias by Stata13.0.Results:A total of 16 studies with benign control and /or healthy control were included.In the studies with benign control,the AUCs of HE4,HE4 /CA125 parallel detection were 0.861 1 ±0. 0399 and 0.8959 ±0.0237 respectively,but there was no significant difference between them (Z =0.749871,P >0. 05);In the studies with benign control,the AUCs of HE4 and HE4 /CA125 were 0.9443 ±0.0153 and 0.9328 ±0. 0132 respectively,but there was no significant difference between them (Z =0.569105,P >0.05).Conclusion:Both HE4 and HE4 /CA125 parallel detection had meaningful values for the diagnosis of ovarian cancer.The detection of HE4 had higher specificity,while the HE4 /CA125 parallel detection had higher sensitivity.But there was no statistical differ-ence between them in diagnosis value of ovarian cancer.