MG7-Ag单检与PG、G-17、Hp感染三者联合检测对胃癌诊断价值的meta分析  

Meta analysis of diagnostic value of Mg7-Ag single detection and combination detection of PG,G-17 and Hp infection in gastric cancer

作　　者：何春燕 解雅淋 韦思琪 李晓晴 姜政[1] HE Chunyan;XIE Yalin;WEI Siqi;LI Xiaoqing;JIANG Zheng(Department of Gastroenterology,First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院消化内科,重庆400016

出　　处：《现代医药卫生》2020年第15期2377-2384,共8页Journal of Modern Medicine & Health

摘　　要：目的探讨胃癌相关抗原(MG7-Ag)单检与胃蛋白酶原(PG)、胃泌素-17(G-17)、幽门螺杆菌(Hp)感染三者联合检测对胃癌的诊断价值。方法2019年9月检索PubMed、中国知网(CNKI)、万方数据知识服务平台、维普资讯中文期刊服务平台(VIP)数据库中MG7-Ag单检或PG、G-17、Hp感染三者联合检测诊断胃癌的文献,检索时限均为建库至2019年9月。由2名研究者按纳入及排除标准独立筛选文献、提取资料,使用Review Manager5.3软件中QUADAS 2工具对所获文献进行质量评价。以胃镜、黏膜活检作为“金标准”,采用Stata/SE 15.1软件分别合并上述2种方法诊断胃癌的灵敏度、特异性、阳性似然比、阴性似然比、诊断比值比、受试者工作特征曲线的曲线下面积(AUC)、相对诊断比值比等。结果共检索2072篇文献,最终纳入22篇,共7166例患者。MG7-Ag单检诊断胃癌的汇总灵敏度为0.67[95%可信区间(95%CI):0.58~0.75]、特异性为0.91(95%CI:0.89~0.93)、阳性似然比为7.75(95%CI:5.76~10.43)、阴性似然比为0.36(95%CI:0.28~0.47)、诊断比值比为21.47(95%CI:13.43~34.31),AUC为0.91(95%CI:0.88~0.93);PG、G-17、Hp感染三者联合检测诊断胃癌的汇总灵敏度为0.78(95%CI:0.53~0.92)、特异性为0.92(95%CI:0.88~0.95)、阳性似然比为10.20(95%CI:6.78~15.37)、阴性似然比为0.24(95%CI:0.10~0.58)、诊断比值比为43.10(95%CI:16.54~112.32),AUC为0.94(95%CI:0.92~0.96)。与MG7-Ag单检比较,PG、G-17、Hp感染三者联合检测诊断胃癌的相对诊断比值比为1.91(95%CI:0.65~5.62)。结论PG、G-17、Hp感染三者联合检测诊断胃癌的灵敏度优于MG7-Ag单检,其余指标在诊断价值方面无明显差别。Objective To investigate the diagnostic value of MG7-Ag single detection and the combination detection of PG,G-17 and helicobacter pylori(Hp)infection in gastric cancer.Methods The literatures about MG7-Ag single detection and the combination detetion of PG,G-17 and Hp infection in diagnosing gastric cancer were retrieved from the databases of PubMed,CNKI,WanFang and VIP databases,and the retrieval time was from the database establishment to September 2019.Two researchers independently screened the literatures,extracted the data according to inclusion and exclusion criteria,and used the QUADAS 2 tool in the Review Manager 5.3 software to conduct the quality evaluation on the obtained literatures.The gastroscopy and mucous membrane biopsy served as the golden standard.Specificity(SEN),specificity(SPE),positive likelihood ratio(PLR),negative likelihood ratio(NLR),diagnostic odds ratio(DOR),area under the ROC curve(AUC)and relative diagnostic odds ratio of the above two methods were pooled respectively by adopting the Stata/SE 15.1 software.Results A total of 2072 articles were retrieved and 22 articles were finally included,involving 7166 patients.The pooled SEN,SPE,PLR,NLR,DOR and AUC of MG7-Ag single detection in diagnosing gastric cancer were 0.67(95%CI:0.58-0.75),0.91(95%CI:0.89-0.93),7.75(95%CI:5.76-10.43),0.36(95%CI:0.28-0.47),21.47(95%CI:13.43-34.31)and 0.91(95%CI:0.88-0.93)respectively;which of combination detection of PG,G-17 and Hp infection were 0.78(95%CI:0.53-0.92),0.92(95%CI:0.88-0.95),10.20(95%CI:6.78-15.37),0.24(95%CI:0.10-0.58),43.10(95%CI:16.54-112.32)and 0.94(95%CI:0.92-0.96)respectively.Compared with MG7-Ag single detection,the relative diagnostic odds ratio of combination detection of PG,G-17 and Hp infection was 1.91(95%CI:0.65-5.62).Conclusion The sensitivity of combination detection of PG,G-17 and Hp infection in diagnosing gastric cancer is better than the MG7-Ag single detection,and the other indicators have no obvious difference in the aspect of diagnostic value.

关 键 词：胃蛋白酶原类 胃泌素类 幽门螺杆菌 胃肿瘤 META分析 胃癌相关抗原 

分 类 号：R735.2[医药卫生—肿瘤] R446.6[医药卫生—临床医学]