NR4A3/NOR1对涎腺腺泡细胞癌诊断价值的Meta分析  

The diagnostic value of NR4A3/NOR1 for acinic cell caicinoma:a Meta-analysis

作　　者：张朝霞[1,2] 于源慧 张晓琴 陈振文[1] 徐义荣[1] ZHANG Zhaoxia;YU Yuanhui;ZHANG Xiaoqin;CHEN Zhenwen;XU Yirong(Fenyang College of Shanxi Medical University,Fenyang 032200,China;Shanxi Fenyang Hospital,Fenyang 032200,China;Guangzhou Medical University,Guangzhou 032200,China;The Second Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学汾阳学院,山西汾阳032200 [2]山西省汾阳医院,山西汾阳032200 [3]广州医科大学,广东广州510000 [4]山西医科大学第二医院,山西太原030001

出　　处：《临床医药实践》2024年第7期514-526,共13页Proceeding of Clinical Medicine

基　　金：山西省医学科技创新团队肿瘤研究团队研究项目(课题编号:2022TD12);恶性肿瘤研究重点实验室研究项目(课题编号:2020ZDSYS18)。

摘　　要：目的:分析和评价NR4A3/NOR1对涎腺腺泡细胞癌(AciCC)的诊断价值。方法:对PubMed和Cochrane图书馆、EMbase数据库、中国知网、维普中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)及万方数据库进行了全面的文献检索(检索时间为建库至2024年2月1日),选择符合条件的纳入研究。纳入文献的质量评估由两名评审员使用Review Manager 5.3(Cochrane协作组)独立进行。采用Stata/SE15.1和Meta-Disc1.4软件进行Meta分析。计算合并敏感度、合并特异度、合并阳性似然比、合并阴性似然比和合并诊断比值比(DOR);绘制受试者操作特征汇总曲线(SROC),并计算曲线下面积(AUC)。此外,还进行了Meta回归分析,以确定异质性的来源。采用Deeks漏斗图检验评估发表偏倚。采用双变量混合效应模型对纳入的文献进行敏感性分析。通过似然比矩阵图及验前概率、验后概率评价其临床适用性。结果:共纳入AciCC患者488例,对照1220例。Meta分析结果显示,NR4A3/NOR1诊断AciCC的合并敏感度、特异度和DOR分别为0.95(95%CI 0.92~0.97),0.99(95%CI 0.98~1.00)和7.90(95%CI 6.65~9.15),SROC的AUC为0.99。在敏感度(I 2=42.26%)方面观测到轻微的异质性,亚组分析和Meta回归显示异质性与标本来源、病例数的多少有关。Fagan验前概率为29%,+LR=134,阳性验后概率为98%,-LR=0.05,阴性验后概率为2%。结论:NR4A3/NOR1是诊断AciCC的潜在生物标志物,具有高敏感度和特异度,但应用中还需要参考其他临床指标。Objective:To analyze and evaluate the value of NR4A3/NOR1 for the diagnosis of acinic cell caicinoma(AciCC).Methods:A comprehensive literature search of PubMed,Cochrane Library,EMBase,CNKI,VIP,CBM and Wanfang(up to February 1,2024)was performed to identify eligible studies.Quality assessment of included literature was performed independently by two reviewers using Review Manager 5.3(Cochrane Collaboration Group).Stata/SE15.1 and Meta-Disc1.4 software were used for meta-analysis.The pooled sensitivity,pooled specificity,pooled positive likelihood ratio,pooled negative likelihood ratio,and pooled diagnostic odds ratio(DOR)were calculated;the summary receiver operating characteristic(SROC)curve was plotted,and the area under the curve(AUC)was calculated.Moreover,Meta-regression analyses were performed to determine the source of heterogeneity.Deeks'funnel plot test was used to assess publication bias.Sensitivity analysis was conducted on the literature included in this study using a bivariate mixed effects model.Likelihood ratio matrix,pre-test probability and post-test probability to evaluate its clinical applicability.Results:This study included a total of 488 AciCC patients and 1220 controls.Meta-analysis results showed that the pooled sensitivity,specificity,and DOR of NR4A3/NOR1 for the diagnosis of AciCC were 0.95(95%CI 0.92~0.97),0.99(95%CI 0.98~1.00)and 7.90(95%CI 6.65~9.15),respectively,and the AUC of the SROC was 0.99.Slight heterogeneity was observed in sensitivity(I 2=42.26%),and subgroup analysis and metaregression showed that heterogeneity is related to the source of the specimen and the number of cases.Fagan pre-test probability was 29%,positive likelihood ratio was 134,positive post-test probability was 98%,negative likelihood ratio was 0.05,negative post-test probability was 2%.Conclusion:NR4A3/NOR1 is a potential biomarker for the diagnosis of AciCC with a high sensitivity and specificity,but other clinical indicators need to be referred to in application.

关 键 词：NR4A3/NOR1 涎腺腺泡细胞癌 META分析 

分 类 号：R743[医药卫生—神经病学与精神病学]