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目的:系统评价血清CA125对卵巢上皮癌综合治疗(手术+化疗)后复发的诊断价值。方法:计算机检索Pub Med、EMBASE、Cochrane Library、Web of Science、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CJFD)、中国科技期刊数据库(CSJD)、中国知网(CNKI)数据库,检验医学专业数据库:IFCC循证实验医学数据库、Medion、CRDdatabase、Bandlier Knowledge library等;灰色文献检索:中国学术会议论文库(CACP)、ISTP,检索期限自建库至2015年12月31日。收集有关血清CA125诊断卵巢上皮癌综合治疗后复发的前瞻性或回顾性队列研究。使用诊断性试验准确性质量评价工具(QUADAS)评价文献质量并提取数据,采用Meta-Disc1.4版软件进行Meta分析。结果:共纳入33篇文献,共2188例患者。Meta分析结果显示,血清CA125对卵巢上皮癌治疗后复发的诊断优势比DOR为11.77(95%Cl为7.16~19.37),灵敏度为67%(95%Cl为65%~70%),特异度为83%(95%Cl为80%~85%),阳性似然比为3.83(95%Cl为2.70~5.43),阴性似然比为0.41(95%Cl为0.35~0.49)。结论:血清CA125阴性排除“卵巢癌复发”的价值较大,而阳性诊断“卵巢癌复发”的价值有待进一步确证。
OBJECTIVE: To systematically evaluate the diagnostic value of serum CA125 in relapse after combined treatment of ovarian epithelial cancer (surgery + chemotherapy). Methods: We searched PubMed, EMBASE, Cochrane Library, Web of Science, CBM, CJFD, CSJD, CNKI, Medical Professional Database: IFCC Evidence-based Experimental Medicine Database, Medion, CRDdatabase, Bandlier Knowledge library, etc .; gray literature search: CACP, ISTP, retrieval period from the library to December 31, Collect prospective or retrospective cohort studies of serum CA125 in the diagnosis of epithelial ovarian cancer recurrence after combined therapy. Meta-analysis was performed using Meta-Disc version 1.4 software using QUADAS to assess the quality of the literature and to extract the data. Results: A total of 33 articles were included, with a total of 2188 patients. Meta analysis showed that the diagnostic predictor of serum CA125 in relapsed ovarian cancer was 11.77 (95% Cl: 7.16-19.37), 67% sensitivity (95% CI: 65% -70%), and specificity The positive likelihood ratio was 83% (95% CI: 2.70 ~ 5.43), and the negative likelihood ratio was 0.41 (95% CI: 0.35 ~ 0.49). Conclusion: The value of serum CA125 negative exclusion “ovarian cancer recurrence ” is larger, but the value of positive diagnosis “ovarian cancer recurrence ” needs to be further confirmed.