磷脂酰肌醇蛋白聚糖-3联合甲胎蛋白检测对原发性肝癌诊断价值的Meta分析  

GPC3 plus alpha fetoprotein versus alpha fetoprotein alone in the diagnosis of hepatocellular carcinoma ： a meta-analysis

作　　者：喻超[1] 黄早早[2] 杨盛力[2] 孙诚谊[1] 江建新[1] 刘平[2] 吴超[2] 何前进[3] 姚弘毅[4] 

机构地区：[1]贵阳医学院附属医院肝胆外科,550001 [2]华中科技大学同济医学院附属梨园医院外科 [3]湖北省黄冈市中心医院普外科 [4]华中科技大学同济医学院附属梨园医院康复科

出　　处：《中华肝胆外科杂志》2014年第8期566-571,共6页Chinese Journal of Hepatobiliary Surgery

基　　金：国家自然科学基金（8116031I）

摘　　要：目的 探讨血清标志物磷脂酰肌醇蛋白聚糖-3（GPC3）联合甲胎蛋白（AFP）检测对比单项检测AFP对原发性肝癌的诊断价值.方法 检索已发表的有关联合检测血清GPC3和AFP及单项检测AFP诊断原发性肝癌的文献.按纳入与排除标准筛选文献、提取数据.采用STATA 12.0软件对诊断准确度指标进行Meta分析.分别绘制综合受试者工作特征曲线比较两者差异.结果 经过筛选最终19篇文献人选.异质性检验提示GPC3和AFP联合检测不存在阈值效应,但存在由其他因素引起的异质性,故选择随机效应模型进行Meta分析.分析显示：AFP单项检测诊断原发性肝癌的汇总灵敏度、特异性分别为0.61、0.93;GPC3联合AFP检测的汇总灵敏度、特异性分别为0.84、0.86.AFP的综合受试者工作特征曲线下面积和Q指数分别为0.81和0.75;GPC3联合AFP检测的综合受试者工作特征曲线下面积和Q指数分别为0.91和0.85.结论 GPC3联合AFP检测能显著提高肝癌诊断的灵敏度,并且特异性仍保持在较高水平（0.86）,有助于肝癌的早期诊断与筛查.Objective To investigate the diagnostic value of serum glypican-3 （GPC3） combined with alpha-fetoprotein （AFP） versus alpha fetoprotein alone for hepatocellular carcinoma.Methods A comprehensive electronic search and additional manual tracking were performed to retrieve published studies addressing the diagnostic value of GPC3 combined with AFP compared with AFP alone for liver cancer.The retrieved literatures were screened and selected according to pre-determined inclusion and exclusion criteria.Data were extracted and analyzed using the software STATA12.0.Summary receiver operating characteristic curves were used to compare test performance of the two.Results Nineteen studies met the inclusion criteria and were included into this study.Heterogeneity existed among these studies,but it was not possibly caused by the threshold effect.Therefore,we used the random effect model for quantitative analysis.The pooled accuracy indicator,sensitivity and specificity were 0.61 and 0.93 for AFP alone,and 0.84 and 0.86 for GPC3 combined with AFP,respectively.The area under summary receiver operating characteristics curve and Q index were 0.81 and 0.75 for AFP alone,and 0.91 and 0.85 for GPC3 combined with AFP.Conclusious GPC3 combined with AFP significantly improved the diagnostic sensitivity,and its specificity remained at a high level （0.86）,indicating that the combined use of GPC3 and AFP is helpful for screening and early diagnosis of liver cancer.

关 键 词：磷脂酰肌醇蛋白聚糖-3 甲胎蛋白 肿瘤标志物 肝癌 META分析 

分 类 号：R735.7[医药卫生—肿瘤]