血清糖链抗原242诊断胰腺癌价值的系统评价  

Value of carbohydrate antigen 242 in diagnosis of pancreatic cancer: A systemic review and meta-analysis

作　　者：张建忠[1] 谢生智[2] 陈海英[3] 

机构地区：[1]武警北京总队第三医院肿瘤科,北京市100041 [2]武警总医院肿瘤二科,北京市100039 [3]武警北京总队第三医院医务处,北京市100041

出　　处：《世界华人消化杂志》2015年第14期2310-2317,共8页World Chinese Journal of Digestology

摘　　要：目的:采用循证医学的方法评估糖链抗原242(carbohydrate antigen 242,CA242)在诊断胰腺癌(pancreatic cancer,PC)诊断价值和诊断效能.方法:计算机检索2014-12-31之前在PubM ed、Embase、Web of science、Cochrane协作网数据库、中国知网、谷歌学术搜索、万方及维普数据库公开发表的文献,并手工检索国内相关医学杂志.按照已定的纳入排除标准结果收集CA242诊断PC的研究文献,采用QUADAS量表进行严格的文献质量评价,利用Meta-Disc 1.4统计软件进行异质性分析和定量合成,并绘制SROC曲线,计算相应验后合并灵敏度和特异度.结果:共纳入13篇英文文献,M e t a分析表明:C A 2 4 2诊断P C的合并灵敏度为71%(95%C I:69%-74%)、合并特异度为87%(95%C I:85%-88%)、合并诊断比值比(diagnostic odds ratio,DOR)为16.51(95%CI:1 0.3 8-2 6.3 7)、阳性似然比(+L R)为5.26(95%C I:3.87-7.14)、阴性似然比(-L R)为0.34(95%CI:0.28-0.42)、SROC曲线下面积为0.8487.结论:CA242在诊断PC诊断效能较CA19-9高,漏诊率和误诊率较低,可以作为筛选、诊断PC和评估预后的实验室指标,值得临床推广.AIM： To assess the value of carbohydrate antigen（CA） 242 in the diagnosis of pancreatic cancer（PC） to provide the best evidence to clinical decision-making. METHODS： Medline, EMBASE, Science Direct, Springer link, CBM, CNKI, Wan fang and VIP database were searched by computer beforeDecember 31, 2014 to collect the articles assessing the diagnostic value of CA242 in pancreatic cancer. Quality assessment was performed using the QUADAS scale. Meta-Disc 1.4 software was used to analyze the heterogeneity of the included articles, plot the SROC curve, and calculate the pooled sensitivity and specificity. RESULTS： A total of 13 English articles were included. The summary sensitivity of CA242 in diagnosing pancreatic cancer was 71%（95%CI： 69%-74%）, the summary specificity was 87%（95%CI： 85%-88%）, the diagnostic odds ratio（DOR） was 16.51（95%CI： 10.38-26.37）, the positive likelihood ratio was 5.26（95%CI： 3.87-7.14）, the negative likelihood ratio was 0.34（95%CI： 0.28-0.42）, and the area under the SROC curve was 0.8487. CONCLUSION： Serum CA242 has higher value in diagnosing pancreatic cancer than CA19-9, and it can be used as an diagnostic marker for pancreatic cancer.

关 键 词：胰腺癌 糖链抗原242 诊断价值 META分析 

分 类 号：R735.9[医药卫生—肿瘤]