流式细胞术检测DNA倍体数对鉴别良恶性肿瘤价值的Meta分析  

Meta Analysis of FCM DNA Ploidy in Distinguishing Benign Tumor from Malignant Ones

作　　者：胡艳芬[1,2] 陈龙[3] 荆超[1,2] 谢贤和[2] 

机构地区：[1]海南大学农学院,海口570100 [2]海南省人民医院肿瘤内科,海口570100 [3]福建医科大学附属第一医院重症医学科,福州350005

出　　处：《中国医科大学学报》2015年第2期136-142,共7页Journal of China Medical University

基　　金：海南省医学科研重点课题(琼卫2012 ZD-02号)

摘　　要：目的探讨流式细胞术（FCM）检测DNA倍体数在良恶性肿瘤鉴别中的应用价值，为临床恶性肿瘤诊断手段的选择提供理论依据。方法由2位研究者独立完成文献筛选，并依据纳入和排除标准，对检索到的所有文献进行二次筛选。使用Meta DiSc1．4对纳入研究的文献数据进行分析，包括异质性检验、敏感度、特异度、诊断比值比（DOR）及受试者工作特征曲线（SROC）等。结果经初筛、补充及二次筛选，共12篇文献纳入研究，包括1340例研究对象，其中恶性肿瘤组516例，良性对照组824例。异质性检验结果显示：灵敏度对数与（1-特异度）对数的Spearman相关系数为-0．343，P=0．275，不存在阈值效应。DOR曲线提示：Cochran．Q=26．49，P=0．0055，表明存在非阈值效应引起的异质性。采用随机效应模型计算合并统计量：敏感度为0．72（95％CI：0．68-0．76，I^2=50．1％）；特异度为0．84（95％CI：0．81～0．86，I^2=65．5％）。绘制DNA倍体数检测良恶性肿瘤的SROC曲线，结果显示：AUC=0．8453，Q＊=0．7768。结论FCM检测DNA异倍体对诊断恶性肿瘤具有较高的准确性，可作为临床良恶性肿瘤鉴别的一项重要辅助手段。Objective To evaluate the application value of DNA ploidy detection using flow cytometry method （ FCM ） in malignant tumor identifi- cation, so as to provide the theoretical basis for the clinical diagnosis of malignant tumors. Methods Two researchers finished the literature screen- ing independently, and all the literatures were given the secondary screening according to the inclusion and exclusion criteria. The included literature data was analyzed by Meta-DiSc 1.4, including heterogeneity test, sensitivity, specificity, diagnostic odds ratio （DOR） and summary receiver operat- ing characteristic （ SROC ） etc. Results Totally 12 literatures were included in the study finally, including a total of 1 340 subjects consisting of 516 cases with malignant tumor and 824 cases with benign tumor. Heterogeneity inspection results showed that the Spearman correlation coefficient of sensitivity logarithm and （1-specificity） logarithm was -0.343 and there was no threshold effect （P = 0.275 ）. DOR curves was Cochran-Q=26.49 （P = 0.005 5 ）, indicating the heterogeneity was caused by non threshold effects. Combined statistical quantity was calculated with a random effects model and the results were as followings ： the sensitivity was 0.72 （95%CI ： 0.68-0.76,I^2=50.1% ） and the specificity 0.84 （95%CI ： 0.81-0.86, I^2= 65.5% ）. SROC curve drawing, DNA ploidy detection of benign and malignant tumors showed AUC=0.845 3 and Q＊=0.776 8. Conclusion FCM DNA heteroploid has a high accuracy for diagnosis of malignant tumor, which can be an important supporting means for the discrimination between benign and malignant tumor.

关 键 词：恶性肿瘤 流式细胞术 DNA倍体 META分析 

分 类 号：R730.43[医药卫生—肿瘤]