RT-PCR检测尿液中细胞角蛋白20mRNA与尿细胞学检查对膀胱癌诊断的荟萃分析  

Diagnostic value of urine cytokeratin 20 mRNA determined by reverse transcription-polymerase chain reaction( RT-PCR)and urinary cytological examination for bladder cancer: A meta-analysis

作　　者：张继旺[1] 王建华[2] 唐治贵[1] 袁永强[1] 

机构地区：[1]重庆医科大学附属永川医院检验科,重庆永川402160 [2]眉山市人民医院妇科,四川眉山620100

出　　处：《临床检验杂志》2015年第1期14-18,共5页Chinese Journal of Clinical Laboratory Science

基　　金：国家高技术研究发展计划(863计划;2011AA02A111)

摘　　要：目的用荟萃(Meta)分析评价逆转录PCR(RT-PCR)技术检测尿液中细胞角蛋白(cytokeratin,CK)20 mRNA和尿细胞学检查对膀胱癌的诊断意义。方法检索Pub Med、Web of Science、The Cochrane Library(2014年第1期)、EMbase、CNKI、VIP、CBM数据库,查找关于用RT-PCR检测尿液中CK20 mRNA与尿细胞学检查诊断膀胱癌的研究。根据QUADAS质量评价标准评价纳入文献质量,用Meta-Disc 1.4软件进行荟萃分析。结果最终纳入11篇研究文献,涉及研究对象共1 631例。Meta分析结果显示,RT-PCR检测尿液中CK20 mRNA和尿细胞学检查诊断膀胱癌的敏感性、特异性、阳性似然比、阴性似然比汇总及95%CI分别是0.80(0.78,0.83)vs 0.53(0.49,0.56)、0.93(0.91,0.95)vs 0.90(0.88,0.93)、12.46(5.22,29.75)vs 6.04(3.37,10.84)、0.22(0.18,0.28)vs 0.51(0.42,0.63)。RT-PCR检测CK20 mRNA和尿细胞学检查诊断膀胱癌的敏感性随肿瘤分级、分期的升高而增高。两种检测方法的SROC曲线下面积分别是0.872 6和0.795 4,Q*指数分别是0.803 0和0.731 9。结论 RT-PCR检测尿液中CK20 mRNA诊断膀胱癌的敏感性高于尿细胞学检查,更适于膀胱癌的诊断。Objective To systematically review the significance of urine cytokeratin 20 （CK20） mRNA determined by RT-PCR and u- rinary cytological examination （UCE） in the diagnosis of bladder cancer. Methods The literatures on the studies which compared the value of urine CK20 mRNA determined by RT-PCR with UCE in the diagnosis of bladder cancer were systematically retrieved from PubMed, Web of Science, The Cochrane Library （before Issue 1, 2014）, Embase, CNKI, VIP and CBM databases. The QUADAS i- tems were used to evaluate the quality of the literatures. The software Meta-Dise 1.4 was used to analyze the data. Results Eleven case-control studies involving in 1 631 subjects were included. The results of meta-analysis showed that the pooled sensitivity, specific- ity, positive likelihood ratio （LR） , negative LR of urine CK20 mRNA and UCE for the diagnosis of bladder cancer were 0.80 （0.78, 0.83） vs0.53 （0.49, 0.56）, 0.93 （0.91,0.95） vs 0.90 （0.88, 0.93）, 12.46 （5.22, 29.75） vs 6.04 （3.37, 10.84） and 0.22 （0.18, 0.28 ） vs 0.51 （0.42, 0.63 ）, respectively. The sensitivity of urine CK20 mRNA and UCE for the diagnosis of bladder cancer increased with the increasing of bladder cancer grade and stage. The areas under summary receiver operating characteristic （SROC） curve were 0.872 6 and 0. 795 4, respectively, and Q ＊ indices were 0.803 0 and 0.731 9, respectively. Conclusion The sensitivity of urine CK20 mRNA determined by RT-PCR for the diagnosis of bladder cancer is superior to that of UCE, and it is more suited to the early diagnosis of bladder cancer.

关 键 词：膀胱肿瘤 细胞角蛋白20 尿细胞学 荟萃分析 

分 类 号：R737.14[医药卫生—肿瘤]