CEA和CYFRA 21—1测定鉴别胸腔积液良恶性的Meta分析  

Clinical value of CEA and CYFRA 21-1 for the differentiation of benign and malignant pleurai effusion by Meta analysis

作　　者：顾平[1] 陈虞梅[1] 黄钢[1] 朱翠英[1] 袁济民[1] 

机构地区：[1]上海交通大学医学院附属仁济医院核医学科,200001

出　　处：《中华核医学杂志》2008年第3期198-202,共5页Chinese Journal of Nuclear Medicine

基　　金：上海市教育委员会科研项目（04BA03）;上海市科学技术委员会科研计划项目（04JC14044）

摘　　要：目的用Meta分析方法系统评价近10年来癌胚抗原（CEA）和细胞角蛋白19片段抗原21-1（CYFRA 21-1）在鉴别良恶性胸腔积液中的价值，并进一步比较两者在诊断效能上的差异。方法收集1996年1月-2007年1月间国内外公开发表的关于CEA和CYFRA 21-1鉴别良恶性胸腔积液的文献，对纳入文献进行方法学质量评估后，运用Q检验评价数据的异质性，合并其灵敏度和特异性，用两者综合受试者工作特征（SROC）曲线下面积（AUC）评价和比较（Z检验）CEA和CYFRA 21-1鉴别良恶性胸腔积液的效能。结果共有19篇文献纳入，研究对象3228例。CEA汇总的灵敏度和特异性[95％可信区间（CI）]为45．9％（43．2％-48．5％）和97．0％（96．0％-97．8％），CYFRA 21-1汇总的灵敏度和特异性（95％CI）为47．3％（44．0％～50．6％）和91．8％（89．5％～93．7％），其结果均存在明显的异质性（P〈0．05）。CEA和CYFRA 21—1的AUC分别为0．7691和0．8213，Z检验比较两者AUC差异无统计学意义（Z=0．45，P〉0．05）。结论CEA和CYFRA 21—1在诊断良恶性胸腔积液时均具有较好的准确性。Objective Pleural effusion is a common clinical complication caused by many benign or malignant diseases. Many published papers presented that tumor-marker assays, such as carcinoembryonic antigen （CEA） and cytokeratin 19 fragment antigen 21-1 （ CYFRA 21-1 ） ,played a vital role on the benign and malignant differentiation. This study aimed to reviewe currently available published papers to evaluate the clinical value of these two markers for the differentiation of benign and malignant pleural effusion. Methods All published data of pleural effusion CEA and CYFRA 21-1 for the differentiation studies from year 1996 to 2007 were reviewed. By methodological qualities and Q test, 19 papers were selected into this study. The overall diagnostic sensitivity, specificity, and area under curve （AUC） from receiver operating char- acteristic （ROC） curve were adopted to compare the value of pleural effusion CEA and CYFRA 21-1 for benign and malignant differentiation used Z test. Results There were 3228 subjects included in this Meta-analysis. The sensitivity and specificity [95% confidence interval （CI） ]of CEA were 45.9% （43.2% -48.5% ） and 97.0% （96.0% -97.8%）, and of CYFRA 21-1, 47.3% （44.0% -50.6%）and 91.8% （89.5% -93.7%）. AUC of CEA and CYFRA 21-1 were 0. 7691 and 0. 8213 respectively （ Z = 0. 45, P 〉 0. 05）. Conclusion Both CEA and CYFRA 21-1 are useful for the differentiation of benign and malignant pleural effusion.

关 键 词：胸腔积液 癌胚抗原 CYFRA 21—1 诊断 鉴别 文献工作 

分 类 号：R686[医药卫生—骨科学]