外周血端粒酶检测对肝细胞癌诊断价值的Meta分析  

Diagnostic value of telomerase activity in peripheral blood in hepatocellular carcinoma:A Meta-analysis

作　　者：郑倩[1] 姜政[1] 赵亚楠[1] 

机构地区：[1]重庆医科大学附属第一医院消化内科,重庆市400016

出　　处：《世界华人消化杂志》2014年第1期125-132,共8页World Chinese Journal of Digestology

摘　　要：目的:通过Meta分析方法评价外周血端粒酶活性检测对肝细胞癌(hepatocellular carcinoma,HCC)诊断的临床价值.方法:检索国内外各类大型数据库近十余年来发表的有关外周血端粒酶活性检测与HCC关系的文献,应用Meta-Disc1.4软件进行定量综合分析,合并总灵敏度、总特异度、阳性预测值(positive likelihood ratio,PLR)、阴性预测值(negative likelihood ratio,NLR)、诊断比值比(diagnostic odds ratio,DOR),同时绘制汇总受试者工作特征曲线(summary ROC curve,SROC)及计算曲线下面积(area under the curve,AUC).结果:按照文献纳入及排除标准最终有12项独立研究纳入本次Meta分析,采用随机效应模型合并总灵敏度为0.85(95%CI:0.82-0.87),总特异度为0.84(95%CI:0.81-0.86),阳性预测值为5.17(95%CI:3.96-6.74),阴性预测值为0.20(95%CI:0.14-0.28),诊断比值比为28.25(95%CI:17.90-44.56).本次Meta分析显示灵敏度与特异度最大交点的均值为0.8419,ROC曲线下面积为0.9098.结论:外周血端粒酶活性检测对HCC有较高的诊断价值,可作为较重要的参考指标之一,但需要更多高质量、大样本、多中心的研究加以验证.AIM： To explore the diagnostic value of telomerase activity in peripheral blood in hepatocellular carcinoma （HCC）. METHODS： We searched the literature for studies on the relationship between the detection of telomerase activity in peripheral blood and HCC published in recent ten years. Meta-Disc1.4 statistical software was applied to perform comprehensive quantitative analysis. We discussed the overall diagnostic features of this assay by plotting the summary ROC curve （SROC） and calculating the area under the curve （AUC）. RESULTS： According to selection and exclusion criteria, 12 independent studies were finally selected in this meta-analysis. The random effects model was used for the meta-analysis, which showed that the comprehensive sensitivity was 0.85 （95%CI： 0.82-0.87）, specificity was 0.84 （95%CI： 0.81-0.86）, comprehensive diagnostic odds ratio was 28.25 （95%CI： 17.90-44.56）, average value of the maximum intersection point of the sensitivity and the specificity was 0.8419, AUC was 0.9098, combined positive likelihood ratio was 5.17 （95%CI： 3.96-6.74）, and negative likelihood ratio was 0.20 （95%CI： 0.14-0.28）. CONCLUSION： Telomerase activity in peripheral blood can be used as an important index to help diagnose HCC, but more high-quality, large-sized, multi-center studies are still required to evaluate its clinical value.

关 键 词：端粒酶活性 肝细胞癌 诊断 META分析 

分 类 号：R735.7[医药卫生—肿瘤]